The comparison between adenocarcinoma and squamous cell carcinoma in lung cancer patients

  • Bing-Yen Wang
  • Jing-Yang Huang
  • Heng-Chung Chen
  • Ching-Hsiung Lin
  • Sheng-Hao Lin
  • Wei-Heng Hung
  • Ya-Fu ChengEmail author
Original Article – Cancer Research



There are several studies comparing the difference between adenocarcinoma (AC) and squamous cell carcinoma (SqCC) of lung cancer. However, seldom studies compare the different overall survival (OS) between AC and SqCC at same clinical or pathological stage. The aim of the study was to investigate the 5-year OS between AC and SqCC groups.


Data were obtained from the Taiwan Society of Cancer Registry. There were 48,296 non-small cell lung cancer (NSCLC) patients analyzed between 2009 and 2014 in this retrospective study. We analyzed both the AC and SqCC groups by age, gender, smoking status, Charlson co-morbidity index (CCI) score, clinical TNM stage, pathological stage, tumor location, histologic grade, pleura invasion, performance status, treatment, stage-specific 5-year OS rate in each clinical stage I–IV and causes of death. We used propensity score matching to reduce the bias.


The AC and SqCC groups are significantly different in age, gender, smoking status, CCI score, clinical TNM stage, pathological stage, tumor location, histologic grade, pleura invasion, performance status, treatment, stage-specific 5-year OS rate in each clinical stage and causes of death (p < 0.0001). The stage-specific 5-year OS rates between AC and SqCC were 79% vs. 47% in stage I; 50% vs. 32% in stage II; 27% vs. 13% in stage III; 6% vs. 2% in stage IV, respectively (all p values < 0.0001).


AC and SqCC have significantly different outcomes in lung cancer. We suggest that these two different cancers should be analyzed separately to provide more precise outcomes in the future.


Non-small cell lung cancer Adenocarcinoma Squamous cell carcinoma Prognosis 



The authors declare that they have no funding.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no competing interests.

Ethics approval

Not applicable.

Informed consent

Not applicable.


  1. Asamura H, Goya T, Koshiishi Y et al (2008) A Japanese Lung Cancer Registry study: prognosis of 13,010 resected lung cancers. J Thorac Oncol 3:46–52CrossRefGoogle Scholar
  2. Berardi R, Brunelli A, Tamburrano T et al (2005) Perioperative anemia and blood transfusions as prognostic factors in patients undergoing resection for non-small cell lung cancers. Lung Cancer 49:371–376CrossRefGoogle Scholar
  3. Buccheri G, Barberis P, Delfino MS (1991) Diagnostic, morphologic, and histopathologic correlates in bronchogenic carcinoma. A review of 1,045 bronchoscopic examinations. Chest 99:809–814CrossRefGoogle Scholar
  4. Chang JW, Asamura H, Kawachi R et al (2009) Gender difference in survival of resected non-small cell lung cancer: histology-related phenomenon? J Thorac Cardiovasc Surg 137:807–812CrossRefGoogle Scholar
  5. Chansky K, Sculier JP, Crowley JJ et al (2009) The International Association for the Study of Lung Cancer Staging Project: prognostic factors and pathologic TNM stage in surgically managed non-small cell lung cancer. J Thorac Oncol 4:792–801CrossRefGoogle Scholar
  6. Chow WH, Blot WJ, Vaughan TL et al (1998) Body mass index and risk of adenocarcinomas of the esophagus and gastric cardia. J Natl Cancer Inst 90:150–155CrossRefGoogle Scholar
  7. Cook MB, Kamangar F, Whiteman DC et al (2010) Cigarette smoking and adenocarcinomas of the esophagus and esophagogastric junction: a pooled analysis from the international BEACON consortium. J Natl Cancer Inst 102:1344–1353CrossRefGoogle Scholar
  8. de Perrot M, Licker M, Bouchardy C et al (2000) Sex differences in presentation, management, and prognosis of patients with non-small cell lung carcinoma. J Thorac Cardiovasc Surg 119:21–26CrossRefGoogle Scholar
  9. Devesa SS, Bray F, Vizcaino AP et al (2005) International lung cancer trends by histologic type: male:female differences diminishing and adenocarcinoma rates rising. Int J Cancer 117:294–299CrossRefGoogle Scholar
  10. Ettinger DS, Wood DE, Aisner DL et al (2017) Non-Small Cell Lung Cancer, Version 5.2017, NCCN Clinical Practice Guidelines in Oncology. J Natl Compr Canc Netw 15:504–535CrossRefGoogle Scholar
  11. Ferguson MK, Wang J, Hoffman PC et al (2000) Sex-associated differences in survival of patients undergoing resection for lung cancer. Ann Thorac Surg 69:245–249 (Discussion 249-250) CrossRefGoogle Scholar
  12. Foegle J, Hedelin G, Lebitasy MP et al (2007) Specific features of non-small cell lung cancer in women: a retrospective study of 1738 cases diagnosed in Bas-Rhin between 1982 and 1997. J Thorac Oncol 2:466–474CrossRefGoogle Scholar
  13. Hitchman SC, Fong GT (2011) Gender empowerment and female-to-male smoking prevalence ratios. Bull World Health Organ 89:195–202CrossRefGoogle Scholar
  14. Howlader NNA, Krapcho M, Miller D, Bishop K, Kosary CL, Yu M, Ruhl J, Tatalovich Z, Mariotto A, Lewis DR, Chen HS, Feuer EJ, Cronin KA (eds). SEER Cancer Statistics Review, 1975-2014, National Cancer Institute. Bethesda, MD,, based on November 2016 SEER data submission, posted to the SEER web site,. April 2017
  15. Hsu LH, Chu NM, Liu CC et al (2009) Sex-associated differences in non-small cell lung cancer in the new era: is gender an independent prognostic factor? Lung Cancer 66:262–267CrossRefGoogle Scholar
  16. Jemal A, Clegg LX, Ward E et al (2004) Annual report to the nation on the status of cancer, 1975–2001, with a special feature regarding survival. Cancer 101:3–27CrossRefGoogle Scholar
  17. Johansson L, Albin M, Jakobsson K et al (1992) Histological type of lung carcinoma in asbestos cement workers and matched controls. Br J Ind Med 49:626–630PubMedPubMedCentralGoogle Scholar
  18. Kawaguchi T, Takada M, Kubo A et al (2010) Performance status and smoking status are independent favorable prognostic factors for survival in non-small cell lung cancer: a comprehensive analysis of 26,957 patients with NSCLC. J Thorac Oncol 5:620–630CrossRefGoogle Scholar
  19. Lagergren J, Bergstrom R, Nyren O (1999) Association between body mass and adenocarcinoma of the esophagus and gastric cardia. Ann Intern Med 130:883–890CrossRefGoogle Scholar
  20. Lewis DR, Check DP, Caporaso NE et al (2014) US lung cancer trends by histologic type. Cancer 120:2883–2892CrossRefGoogle Scholar
  21. Lopez Guerra JL, Gomez DR, Lin SH et al (2013) Risk factors for local and regional recurrence in patients with resected N0-N1 non-small-cell lung cancer, with implications for patient selection for adjuvant radiation therapy. Ann Oncol 24:67–74CrossRefGoogle Scholar
  22. Lortet-Tieulent J, Soerjomataram I, Ferlay J et al (2014) International trends in lung cancer incidence by histological subtype: adenocarcinoma stabilizing in men but still increasing in women. Lung Cancer 84:13–22CrossRefGoogle Scholar
  23. Meza R, Meernik C, Jeon J et al (2015) Lung cancer incidence trends by gender, race and histology in the United States, 1973-2010. PLoS One 10:e0121323CrossRefGoogle Scholar
  24. Paris C, Benichou J, Saunier F et al (2003) Smoking status, occupational asbestos exposure and bronchial location of lung cancer. Lung Cancer 40:17–24CrossRefGoogle Scholar
  25. Pesch B, Kendzia B, Gustavsson P et al (2012) Cigarette smoking and lung cancer–relative risk estimates for the major histological types from a pooled analysis of case-control studies. Int J Cancer 131:1210–1219CrossRefGoogle Scholar
  26. Pfannschmidt J, Muley T, Bulzebruck H et al (2007) Prognostic assessment after surgical resection for non-small cell lung cancer: experiences in 2083 patients. Lung Cancer 55:371–377CrossRefGoogle Scholar
  27. Puri V, Garg N, Engelhardt EE et al (2010) Tumor location is not an independent prognostic factor in early stage non-small cell lung cancer. Ann Thorac Surg 89:1053–1059CrossRefGoogle Scholar
  28. Rice TW, Blackstone EH, Rusch VW (2010) 7th edition of the AJCC Cancer Staging Manual: esophagus and esophagogastric junction. Ann Surg Oncol 17:1721–1724CrossRefGoogle Scholar
  29. Sakurai H, Asamura H, Goya T et al (2010) Survival differences by gender for resected non-small cell lung cancer: a retrospective analysis of 12,509 cases in a Japanese Lung Cancer Registry study. J Thorac Oncol 5:1594–1601CrossRefGoogle Scholar
  30. Siewert JR, Stein HJ, Feith M et al (2001) Histologic tumor type is an independent prognostic parameter in esophageal cancer: lessons from more than 1,000 consecutive resections at a single center in the Western world. Ann Surg 234:360–367 (Discussion 368-369) CrossRefGoogle Scholar
  31. Strand TE, Rostad H, Moller B et al (2006) Survival after resection for primary lung cancer: a population based study of 3211 resected patients. Thorax 61:710–715CrossRefGoogle Scholar
  32. Torre LA, Bray F, Siegel RL et al (2015) Global cancer statistics, 2012. CA Cancer J Clin 65:87–108CrossRefGoogle Scholar
  33. Toyoda Y, Nakayama T, Ioka A et al (2008) Trends in lung cancer incidence by histological type in Osaka, Japan. Jpn J Clin Oncol 38:534–539CrossRefGoogle Scholar
  34. Travis WD, Lubin J, Ries L et al (1996) United States lung carcinoma incidence trends: declining for most histologic types among males, increasing among females. Cancer 77:2464–2470CrossRefGoogle Scholar
  35. Wang BY, Huang JY, Cheng CY et al (2013) Lung cancer and prognosis in taiwan: a population-based cancer registry. J Thorac Oncol 8:1128–1135 (Official publication of the International Association for the Study of Lung Cancer) CrossRefGoogle Scholar
  36. Wisnivesky JP, Halm EA (2007) Sex differences in lung cancer survival: do tumors behave differently in elderly women? J Clin Oncol 25:1705–1712CrossRefGoogle Scholar
  37. Wisnivesky JP, Henschke C, McGinn T et al (2005) Prognosis of Stage II non-small cell lung cancer according to tumor and nodal status at diagnosis. Lung Cancer 49:181–186CrossRefGoogle Scholar
  38. Youlden DR, Cramb SM, Baade PD (2008) The International Epidemiology of Lung Cancer: geographical distribution and secular trends. J Thorac Oncol 3:819–831CrossRefGoogle Scholar

Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Division of Thoracic Surgery, Department of SurgeryChanghua Christian HospitalChanghua CityTaiwan
  2. 2.School of MedicineChung Shan Medical UniversityTaichungTaiwan
  3. 3.School of MedicineKaohsiung Medical UniversityKaohsiungTaiwan
  4. 4.Institute of Genomics and BioinformaticsNational Chung Hsing UniversityTaichungTaiwan
  5. 5.Department of Medical ResearchChung Shan Medical University HospitalTaichungTaiwan
  6. 6.Division of Chest Medicine, Department of Internal MedicineChanghua Christian HospitalChanghua CityTaiwan

Personalised recommendations