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Prognostic significance of CT-emphysema score in patients with advanced squamous cell lung cancer
Young Saing Kim1, Eun Young Kim2, Hee Kyung Ahn1
1Division of Hematology and Oncology, Department of Internal Medicine, Gachon University Gil Medical Center, Incheon, Republic of Korea ;
Background:
Although emphysema is a known independent risk factor of lung cancer, no study has addressed the prognostic impact of computed tomography (CT)-emphysema score in advanced stage lung cancer.
Methods:
For 84 consecutive patients with stage IIIB and IV squamous cell lung cancer that underwent palliative chemotherapy, severity of emphysema was semi-quantitatively scored using baseline chest CT images according to the Goddard scoring system (possible scores range, 0-24). The cutoff of high CT-emphysema score was determined using the maximum chi-squared test and the prognostic significance of the high CT-emphysema score was evaluated using Kaplan-Meier analysis and Cox proportional hazards analysis.
Results:
The median CT-emphysema score was 5 (range, 0-22). Patients with a high CT-emphysema score (≥4) tended to have poorer overall survival (OS) (median: 6.3 vs. 13.7 months) than those with a score of <4 (P=0.071). Multivariable analysis revealed that a higher CT-emphysema score was a significant independent prognostic factor for poor OS [hazard ratio (HR) =2.06; 95% confidence interval (CI), 1.24-3.41; P=0.005), along with no response to first-line therapy (P=0.009) and no second-line therapy (P<0.001).
Conclusions:
CT-emphysema score is significantly associated with poor prognosis in patients with advanced squamous cell lung cancer.
