TY - JOUR T1 - 5 protein-based signature for resectable lung squamous cell carcinoma improves the prognostic performance of the TNM staging JF - Thorax JO - Thorax DO - 10.1136/thoraxjnl-2018-212194 SP - thoraxjnl-2018-212194 AU - Elena Martínez-Terroba AU - Carmen Behrens AU - Jackeline Agorreta AU - Eduard Monsó AU - Laura Millares AU - Enriqueta Felip AU - Rafael Rosell AU - José Luis Ramirez AU - Ana Remirez AU - Wenceslao Torre AU - Ignacio Gil-Bazo AU - Miguel A Idoate AU - Juan P de-Torres AU - Ruben Pio AU - Ignacio I Wistuba AU - María J Pajares AU - Luis M Montuenga Y1 - 2018/11/24 UR - http://thorax.bmj.com/content/early/2018/11/23/thoraxjnl-2018-212194.abstract N2 - Introduction Prognostic biomarkers have been very elusive in the lung squamous cell carcinoma (SCC) and none is currently being used in the clinical setting. We aimed to identify and validate the clinical utility of a protein-based prognostic signature to stratify patients with early lung SCC according to their risk of recurrence or death.Methods Patients were staged following the new International Association for the Study of Lung Cancer (IASLC) staging criteria (eighth edition, 2018). Three independent retrospective cohorts of 117, 96 and 105 patients with lung SCC were analysed to develop and validate a prognostic signature based on immunohistochemistry for five proteins.Results We identified a five protein-based signature whose prognostic index (PI) was an independent and significant predictor of disease-free survival (DFS) (p<0.001; HR=4.06, 95% CI 2.18 to 7.56) and overall survival (OS) (p=0.004; HR=2.38, 95% CI 1.32 to 4.31). The prognostic capability of PI was confirmed in an external multi-institutional cohort for DFS (p=0.042; HR=2.01, 95% CI 1.03 to 3.94) and for OS (p=0.031; HR=2.29, 95% CI 1.08 to 4.86). Moreover, PI added complementary information to the newly established IASLC TNM 8th edition staging system. A combined prognostic model including both molecular and anatomical (TNM) criteria improved the risk stratification in both cohorts (p<0.05).Conclusion We have identified and validated a clinically feasible protein-based prognostic model that complements the updated TNM system allowing more accurate risk stratification. This signature may be used as an advantageous tool to improve the clinical management of the patients, allowing the reduction of lung SCC mortality through a more accurate knowledge of the patient’s potential outcome. ER -