Lymphatic invasion is a more significant prognostic factor than visceral pleural invasion in non‐small cell lung cancer with tumours of 3 cm or less. Issue 6 (5th April 2017)

• Record Type: Journal Article
• Authors: Moon, Youngkyu; Park, Jae Kil; Lee, Kyo Young; Sung, Sook Whan
• Is Part Of: Respirology. Volume 22:Issue 6(2017)
• Page Start: 1179
• Page End: 1184
• Publication Date: 2017-04-05
• Subjects: lung cancer -- sublobar resection -- lymphatic invasion -- visceral pleural invasion; Respiratory organs -- Diseases -- Periodicals; Respiratory organs -- Periodicals; 612.2
• DOI: 10.1111/resp.13029
• Languages: English
• ISSNs: 1323-7799

Abstract

ABSTRACT: Background and objective: Visceral pleural invasion is an upstaging factor that increases cancer staging from stage IA to IB for tumours of 3 cm or less. However, lymphatic invasion has not been associated with the tumour–node–metastasis (TNM) staging system. The purpose of this study was to compare visceral pleural invasion and lymphatic invasion as prognostic factors. Methods: We retrospectively reviewed 353 consecutive patients who underwent curative resection for stage I non‐small cell lung cancer (NSCLC) tumours of 3 cm or less. Patients were divided into three groups and compared. Group A contained no invasions; group B contained visceral pleural invasion only and group C had lymphatic invasion only. Results: Group A patients had stage IA, but group B patients had stage IB tumours. However, group C patients had stage IA tumours. The 5‐year recurrence‐free survival for the three groups was 86.2%, 71.5% and 48.0%, respectively. There was a significant difference in survival between groups A and C ( P = 0.001).Survival was not different between groups A and B ( P = 0.547). In a multivariate analysis conducted to determine risk factors for recurrence, lymphatic invasion was a significant independent risk factor for recurrence (hazard ratio = 2.570, P = 0.006). Pleural invasion was not a significant risk factor for recurrence. Conclusion: Lymphatic invasion is a more significant prognostic factor than visceral pleural invasion in NSCLC of 3 cm or less. Abstract : Visceral pleural invasion is an upstaging factor, but lymphatic invasion has not been adopted as a descriptor in the tumour–node–metastasis (TNM) classification. In our study, lymphatic invasion is a more significant prognostic factor than visceral pleural invasion in non‐small cell lung cancer with tumours of 3 cm or less.