Characteristics of Peripheral versus Central Lung Cancer Since 2000

So Young Ock; Tae Won Jang; You Jin Han; Go Eun Yeo; Eun Jung Kim; Won Hyoung Lee; Nam Kyu Kim

doi:10.7180/kmj.2014.29.1.47

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Ock, Jang, Han, Yeo, Kim, Lee, and Kim: Characteristics of Peripheral versus Central Lung Cancer Since 2000

Original Article

Kosin Medical Journal 2014;29(1):47-52.

Published online: 17 December 2014

DOI: https://doi.org/10.7180/kmj.2014.29.1.47

Characteristics of Peripheral versus Central Lung Cancer Since 2000

So Young Ock, Tae Won Jang, You Jin Han, Go Eun Yeo, Eun Jung Kim, Won Hyoung Lee, Nam Kyu Kim

Department of Internal Medicine, College of Medicine, Kosin University, Busan, Korea

Corresponding Author: So Young Ock, Deparment of Internal Medicine, College of Medicine, Kosin University, 34 Amnamdong, Seo-gu, Busan, 602-702, Korea TEL: +82-51-990-6460 FAX: +82-51-990-3049 E-mail: oaksoyoung@naver.com

Received 30 July 2013 Revised 8 February 2014 Accepted 12 February 2014

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Objectives

The aim of this study was to explore the changes of bronchoscopic features according to epidemiologic change of lung cancer.

Methods

We performed a retrospective review of the clinical characteristics of 1,139 lung cancer patient who underwent bronchoscopy at Kosin University Hospital from January 2000 to December 2010.

Results

The age of patients increased significantly during the last decade (P < 0.001). The most common histological type was adenocarcinoma (38.1%), followed by squamous carcinoma (35.7%) and small cell carcinoma (15.3%). There was an increasing incidence of adenocarcinoma over the time (P < 0.001). Bronchoscopic feature were divided into two classes; central type, peripheral type. The peripheral type was predominant (62.3%). The proportion of peripheral type has been increased in process of time (49.7% vs. 63.7% vs. 73.7%; P < 0.01). Among the major histopathologic type of lung cancer, adenocarcinoma (81.3%) and unclassifiable non-small-cell lung cancer (73.4%), small cell carcinoma (56.9%) were associated with preferential occurrence of peripheral type. Squamous cell carcinoma of the lung more often arised in central type (59%). However, the proportion of peripheral squamous cell carcinoma has been increased. On the subgroup analysis, the median survival time of peripheral type with adenocarcinoma and small cell carcinoma were longer than central type (P < 0.05).

Conclusions

The age of the lung cancer patients at diagnosis was getting older. The most frequent histopathologic type was adenocarcinoma. The proportion of peripheral type lung cancer gradually increased over the time. The survival time of peripheral type lung cancer was longer than central type.

Keywords: Bronchoscopy, Lung cancer

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Fig. 1.

Keplan-meier curves of the over all survival of patients according to tumor location.

Table 1.

Patient characteristics

Characteristic	No. of patients (%)
Age (years)	64 ± 9.9
Gender
Male	910 (79.9)
Female	229 (20.1)
Smoking status
Current smoker or ever smoker	508 (72.1)
Never smoker	197 (27.9)
ECOG
0-1	739 (65.3)
2-4	393 (34.7)
Treatment
Operation	169 (15)
Chemotherapy	501 (44)
Rradiation or Concurrent chemoradiotherapy	191 (17)
Best supportive care	276 (24)

No: Number, ECOG: Eastern Cooperative Oncology Group.

Table 2.

Annual trends of clinical characteristics of lung cancer in Kosin University

	2000-2003	2004-2004	2008-2010	P-value
No of patients (%)	380 (33.4)	386 (33.9)	373 (32.7)
Age, yr (mean ± SD)	62.0 ± 10.753	64.1 ± 9.374	65.2 ± 9.450	<0.001
ADC/Non-ADC	32.1/67.9	37.3/62.7	42.4/57.6	0.014
Smoker/non-smoker	69.9/30.1	72.4/27.6	72.9/27.1	0.783
Stage (%)
I-II/III/IV	9.0/51.2/39.8	15.6/41.4/42.9	15.2/37.1/47.6	0.002
L/E	40.4/59.6	47.4/52.6	41.4/58.6	0.761
Treatment				0.001
Surgery	10.3	17.9	16.4
Radiation & Chemoradiotherpy	16.8	23.3	10
Chemotherapy	41.3	39.6	51.5
BSC	31.6	19.2	22.1
Central/peripheral type	50.3/49.7	36.3/63.7	26.3/73.7	<0.0001
Polyphoid lesion	12.9	10.9	9.4
Nodular lesion	25	19.9	10.5
Subepithelial lesion	12.4	5.4	6.4
No endobronchial lesion	49.7	63.7	73.7

ADC: adenocarcinoma, ECOG: Eastern Cooperative Oncology, Group, L: limited, E: extensive, BSC: best supportive care.

Table 3.

Comparison clinical characteristics central type lung cancer with periphera lung cancer

	Central type	Peripheral type	P-value
No of patients (%)	429 (37.7)	710 (62.3)
Age, yr (mean ±10.753	64 ± 10.46	64 ± 9.70	0.214
ADC/Non-ADC	18.2/81.8	48.7/51.3	0.001
Smoker/non-smoker	83.1/16.9	66.2/33.8	0.001
Smoking, pack-yrs	41.5	39.8	0.373
ECOG 0-1/2-4	65.1/34.9	65.4/34.6	0.484
Stage (%)
I-II/III/IV	12.7/49.7/37.6	13.6/39.6/46.8	0.007
L/E	50.0/50.0	50.4/49.6	0.534
Survival time (month)	14.5	16.7	0.001
Adenocarcioma	14.5 ± 0.294	17.4 ± 0.443	0.001
Squamus cell	12.8 ± 2.917	12.8 ± 1.082	0.961
NSCLC	14.9 ± 1.628	15.5 ± 1.230	0.218
Small cell	14.2 ± 0.805	15.7 ± 0.995	0.038

ADC: adenocarcinoma, ECOG: Eastern Cooperative Oncology, Group, L: limited, E: extensive.

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