Lymphatic invasion predicts survival in patients with early node-negative non-small cell lung cancer
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Lymphatic invasion predicts survival in patients with early node-negative non-small cell lung cancer. / Nentwich, Michael F; Bohn, Benjamin A; Uzunoglu, Faik G; Reeh, Matthias; Quaas, Alexander; Grob, Tobias J; Perez, Daniel; Kutup, Asad; Bockhorn, Maximilian; Izbicki, Jakob R; Vashist, Yogesh K.
in: J THORAC CARDIOV SUR, Jahrgang 146, Nr. 4, 01.10.2013, S. 781-7.Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung
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TY - JOUR
T1 - Lymphatic invasion predicts survival in patients with early node-negative non-small cell lung cancer
AU - Nentwich, Michael F
AU - Bohn, Benjamin A
AU - Uzunoglu, Faik G
AU - Reeh, Matthias
AU - Quaas, Alexander
AU - Grob, Tobias J
AU - Perez, Daniel
AU - Kutup, Asad
AU - Bockhorn, Maximilian
AU - Izbicki, Jakob R
AU - Vashist, Yogesh K
N1 - Copyright © 2013 The American Association for Thoracic Surgery. Published by Mosby, Inc. All rights reserved.
PY - 2013/10/1
Y1 - 2013/10/1
N2 - OBJECTIVE: The aim of this study was to assess the influence of lymphatic and vascular invasion on overall survival in patients with surgically resected non-small cell lung cancer (NSCLC) without lymph node and distant metastases.METHODS: From January 1999 to December 2009, a total of 190 NSCLC patients with node-negative pT1-pT4 disease underwent radical resection with lymphadenectomy. Pathologic reports were reclassified to the TNM-7 version, and the influence of lymphatic and vascular invasion on overall survival was examined using Kaplan-Meier and adjusted Cox proportional hazards analyses.RESULTS: Lymphatic invasion was present in 34 (17.9%) and vascular invasion in 28 (14.7%) of 190 cases. Lymphatic and vascular invasions were correlated with higher Union for International Cancer Control stages (P = .056 and P = .011, respectively) and poor differentiated tumors (P = .051 and P = .012, respectively). There was no difference between pT1a and pT1b tumors in the presence of lymphatic (P = .912) or vascular (P = .134) invasion. Survival analyses revealed lymphatic (P < .001) and vascular (P = .008) invasion as statistically significant for the entire study population. Multivariable Cox analysis adjusted for age, Union for International Cancer Control stage, and lymphatic and vascular invasion confirmed lymphatic, but not vascular, invasion as an independent prognostic factor (P < .001; hazard ratio, 3.002; 95% confidence interval, 1.780-5.061). Especially in early stages, lymphatic invasion was associated with poorer overall survival in pT1a (P < .001), pT1b (P = .019), and pT2a (P = .028) tumors.CONCLUSIONS: Lymphatic invasion represents an independent risk factor for node-negative NSCLC. Its implications on therapy decision making should be further evaluated, especially in early stages.
AB - OBJECTIVE: The aim of this study was to assess the influence of lymphatic and vascular invasion on overall survival in patients with surgically resected non-small cell lung cancer (NSCLC) without lymph node and distant metastases.METHODS: From January 1999 to December 2009, a total of 190 NSCLC patients with node-negative pT1-pT4 disease underwent radical resection with lymphadenectomy. Pathologic reports were reclassified to the TNM-7 version, and the influence of lymphatic and vascular invasion on overall survival was examined using Kaplan-Meier and adjusted Cox proportional hazards analyses.RESULTS: Lymphatic invasion was present in 34 (17.9%) and vascular invasion in 28 (14.7%) of 190 cases. Lymphatic and vascular invasions were correlated with higher Union for International Cancer Control stages (P = .056 and P = .011, respectively) and poor differentiated tumors (P = .051 and P = .012, respectively). There was no difference between pT1a and pT1b tumors in the presence of lymphatic (P = .912) or vascular (P = .134) invasion. Survival analyses revealed lymphatic (P < .001) and vascular (P = .008) invasion as statistically significant for the entire study population. Multivariable Cox analysis adjusted for age, Union for International Cancer Control stage, and lymphatic and vascular invasion confirmed lymphatic, but not vascular, invasion as an independent prognostic factor (P < .001; hazard ratio, 3.002; 95% confidence interval, 1.780-5.061). Especially in early stages, lymphatic invasion was associated with poorer overall survival in pT1a (P < .001), pT1b (P = .019), and pT2a (P = .028) tumors.CONCLUSIONS: Lymphatic invasion represents an independent risk factor for node-negative NSCLC. Its implications on therapy decision making should be further evaluated, especially in early stages.
KW - Adult
KW - Aged
KW - Aged, 80 and over
KW - Carcinoma, Non-Small-Cell Lung
KW - Female
KW - Humans
KW - Kaplan-Meier Estimate
KW - Lung Neoplasms
KW - Lymph Node Excision
KW - Lymphatic Metastasis
KW - Male
KW - Middle Aged
KW - Multivariate Analysis
KW - Neoplasm Invasiveness
KW - Neoplasm Staging
KW - Pneumonectomy
KW - Proportional Hazards Models
KW - Retrospective Studies
KW - Risk Assessment
KW - Risk Factors
KW - Time Factors
KW - Treatment Outcome
U2 - 10.1016/j.jtcvs.2013.04.037
DO - 10.1016/j.jtcvs.2013.04.037
M3 - SCORING: Journal article
C2 - 23778087
VL - 146
SP - 781
EP - 787
JO - J THORAC CARDIOV SUR
JF - J THORAC CARDIOV SUR
SN - 0022-5223
IS - 4
ER -
