THE ROLE OF HISTOPATHOLOGIC SUBTYPING IN PREDICTING NEUROLOGIC COMPLICATIONS IN SMALL-CELL LUNG-CANCER

We examined the significance of histologic subtyping of small cell lun g cancer (SCLC) as a prognostic factor for neurologic complications an d in particular central nervous system (CNS) metastases. Pretreatment material of 239 consecutive patients with SCLC was retrospectively ree xamined according to the histologic subclassification of the Pathology Panel of the International Association for the Study of Lung Cancer. Besides the classic small cell type (n=178), this subclassification di stinguishes two variant cell types: mixed (n=31) and combined (n=1), w hich were treated as one group in the further statistical analysis. Tw enty nine cases were not classified, for the following reasons: autops y material only (n=14), slides missing (n=7), and initial SCLC diagnos is changed (n=8). The results showed that neurologic complications reg istered in a prospective neurologic follow-up were common in both subt ypes and predominantly metastatic in nature. The data did not reveal a ny significant difference between histologic subtypes with regard to C NS metastases and brain metastatic-free survival. Paraneoplastic syndr omes tended to occur more frequently in patients with classic small ce ll type. However, this relationship needs further study. It was conclu ded that no prognostic relevance exists for histologic subtyping with respect to neurologic complications.