Histotype in Non-Small Cell Lung Cancer Therapy and Staging: The Emerging Role of an Old and Underrated Factor

Therapeutic management of lung cancer is mainly based on a dichotomic distinction between small cell (SCLC) and non-small cell lung cancer (NSCLC), tumour stage and patient performance status. However, crossing the recent data emerging from molecular studies of gene expression profiling, from the new 2004-WHO histopathological classification of lung tumours as well as from clinical trials with newl targeted therapies against EGFR (gefitinib/ erlotinib/cetuximab), it seems that a better definition of tumour histotype in NSCLC might somehow be helpful in predicting clinical response and patient outcome. In addition, lung tumours histotype may deeply influence the tumour stage when assessing parameters (i.e., pulmonary atelectasis, pleural invasion, tumour dimension) defining the current lung tumours staging system. Thus, in this review we analyze the possible future role of histotype as an important influencing factor in the clinical management of patients with NSCLC.