Clinical Features and Outcome of NOT-OTHERWISE SPECIFIED Lung Cancer via Small Biopsy Materials

Objectives: Non-small cell lung cancer(NSCLC) can be diagnosed with small biopsy specimens due to the fact that 70% of patients are unresectable in advanced stages. Carcinomas lacking clear differentiation by morphology and special stains are classified as NSCLC, not otherwise specified (10%). The aim of this study was to investigate the clinical and survival characteristics of patients with NOS diagnosed with small biopsy specimens as the primary endpoint, and to evaluate mortality such as interstitial lung disease and COPD as secondary targets. Methods: Retrospective population-based study of 196 NSCLC-NOS patients diagnosed histologically or cytologically via small tissue samples (bronchoscopic bronchial mucosa sampling, transthoracic lung biopsy, pleural fluid cytology (including cytobloc), conventional or EBUS lymph node aspiration specimens) from the Atatürk Chest Diseases and Thoracic Surgery Health Practice and Research Center from January 2011 to December 2016. Results: The majority of the196 cases included in the study were advanced stage(55.61%) and male gender (95.4%). The percentage of 35.71 EGFR19, EGFR21, ALK and 32.14% of ROS1 mutation analysis were performed; 5.71% had EGFR exon 19, 1.42% had EGFR exon 21 deletion, 4.28% had ALK and 1.58% had ROS1 positivity. According to lymph node staging system, N3 group had significant effect on survival [N3-N0 (p=0.001), N3-N2 (p=0.035)]. In the 8th staging system, the effect of the M1a and M1c groups on the total survival was found to be significant (14.45±11.9 month 5.92±5.6 month, p=0.017). The survival rate was significantly higher in stage IIIA and B cases than in both IV staging systems (p