Prognostic impact of microscopic vessel invasion and visceral pleural invasion in non-small cell lung cancer a retrospective analysis of 2657 patients

Shinya Neri, Junji Yoshida, Genichiro Ishii, Yuki Matsumura, Keiju Aokage, Tomoyuki Hishida, Kanji Nagai

Research output: Contribution to journalArticle

26 Citations (Scopus)

Abstract

Objective: We aimed to assess the prognostic significance of microscopic vessel invasion (MVI) and visceral pleural invasion (VPI) in non-small cell lung cancer (NSCLC). Background: VPI is included in the current tumor-node- metastasis (TNM) classification in NSCLC; however, MVI is not incorporated in TNM classification. Methods: From August 1992 to December 2009, 2657 consecutive patients with pathological T1-4N0-2M0 NSCLC underwent complete resection. In addition to conventional staging factors, we evaluated MVI histologically and analyzed its significance in NSCLC recurrence prognosis. The recurrence-free period in several NSCLC subgroups was analyzed using the Kaplan-Meier method and Cox regression analysis. Results: The proportion of patients with a 5-year recurrence-free period was 52.6% and 87.5%, respectively, in those with and without MVI (P < 0.001). Multivariate analysis showed that MVI, similarly to VPI, was found to be an independently significant predictor of recurrence [hazard ratio (HR): 2.78]. In particular, MVI and VPI were the 2 strongest significant independent predictors of recurrence in 1601 patients with pathological stage I disease treated without adjuvant chemotherapy (HR: 2.74 and 1.84, respectively). In each T subgroup analysis, evident and significant separation of the recurrence-free proportion curves were observed among the 3 groups (VPI and MVI absent, VPI or MVI present, and VPI and MVI present). Conclusions: This study demonstrated that MVI was a significant independent risk factor for recurrence in patients with a resected T1-4N0-2M0 NSCLC. Further data on MVI prognostic impact should be collected for the next revision of the TNM staging system.

Original languageEnglish
Pages (from-to)383-388
Number of pages6
JournalAnnals of Surgery
Volume260
Issue number2
DOIs
Publication statusPublished - 2014
Externally publishedYes

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Non-Small Cell Lung Carcinoma
Recurrence
Neoplasm Metastasis
Neoplasms
Adjuvant Chemotherapy
Multivariate Analysis
Regression Analysis

Keywords

  • Non-small cell lung cancer
  • Pleural invasion
  • Vessel invasion

ASJC Scopus subject areas

  • Surgery
  • Medicine(all)

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Prognostic impact of microscopic vessel invasion and visceral pleural invasion in non-small cell lung cancer a retrospective analysis of 2657 patients. / Neri, Shinya; Yoshida, Junji; Ishii, Genichiro; Matsumura, Yuki; Aokage, Keiju; Hishida, Tomoyuki; Nagai, Kanji.

In: Annals of Surgery, Vol. 260, No. 2, 2014, p. 383-388.

Research output: Contribution to journalArticle

Neri, Shinya ; Yoshida, Junji ; Ishii, Genichiro ; Matsumura, Yuki ; Aokage, Keiju ; Hishida, Tomoyuki ; Nagai, Kanji. / Prognostic impact of microscopic vessel invasion and visceral pleural invasion in non-small cell lung cancer a retrospective analysis of 2657 patients. In: Annals of Surgery. 2014 ; Vol. 260, No. 2. pp. 383-388.
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abstract = "Objective: We aimed to assess the prognostic significance of microscopic vessel invasion (MVI) and visceral pleural invasion (VPI) in non-small cell lung cancer (NSCLC). Background: VPI is included in the current tumor-node- metastasis (TNM) classification in NSCLC; however, MVI is not incorporated in TNM classification. Methods: From August 1992 to December 2009, 2657 consecutive patients with pathological T1-4N0-2M0 NSCLC underwent complete resection. In addition to conventional staging factors, we evaluated MVI histologically and analyzed its significance in NSCLC recurrence prognosis. The recurrence-free period in several NSCLC subgroups was analyzed using the Kaplan-Meier method and Cox regression analysis. Results: The proportion of patients with a 5-year recurrence-free period was 52.6{\%} and 87.5{\%}, respectively, in those with and without MVI (P < 0.001). Multivariate analysis showed that MVI, similarly to VPI, was found to be an independently significant predictor of recurrence [hazard ratio (HR): 2.78]. In particular, MVI and VPI were the 2 strongest significant independent predictors of recurrence in 1601 patients with pathological stage I disease treated without adjuvant chemotherapy (HR: 2.74 and 1.84, respectively). In each T subgroup analysis, evident and significant separation of the recurrence-free proportion curves were observed among the 3 groups (VPI and MVI absent, VPI or MVI present, and VPI and MVI present). Conclusions: This study demonstrated that MVI was a significant independent risk factor for recurrence in patients with a resected T1-4N0-2M0 NSCLC. Further data on MVI prognostic impact should be collected for the next revision of the TNM staging system.",
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T1 - Prognostic impact of microscopic vessel invasion and visceral pleural invasion in non-small cell lung cancer a retrospective analysis of 2657 patients

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AU - Yoshida, Junji

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AU - Matsumura, Yuki

AU - Aokage, Keiju

AU - Hishida, Tomoyuki

AU - Nagai, Kanji

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N2 - Objective: We aimed to assess the prognostic significance of microscopic vessel invasion (MVI) and visceral pleural invasion (VPI) in non-small cell lung cancer (NSCLC). Background: VPI is included in the current tumor-node- metastasis (TNM) classification in NSCLC; however, MVI is not incorporated in TNM classification. Methods: From August 1992 to December 2009, 2657 consecutive patients with pathological T1-4N0-2M0 NSCLC underwent complete resection. In addition to conventional staging factors, we evaluated MVI histologically and analyzed its significance in NSCLC recurrence prognosis. The recurrence-free period in several NSCLC subgroups was analyzed using the Kaplan-Meier method and Cox regression analysis. Results: The proportion of patients with a 5-year recurrence-free period was 52.6% and 87.5%, respectively, in those with and without MVI (P < 0.001). Multivariate analysis showed that MVI, similarly to VPI, was found to be an independently significant predictor of recurrence [hazard ratio (HR): 2.78]. In particular, MVI and VPI were the 2 strongest significant independent predictors of recurrence in 1601 patients with pathological stage I disease treated without adjuvant chemotherapy (HR: 2.74 and 1.84, respectively). In each T subgroup analysis, evident and significant separation of the recurrence-free proportion curves were observed among the 3 groups (VPI and MVI absent, VPI or MVI present, and VPI and MVI present). Conclusions: This study demonstrated that MVI was a significant independent risk factor for recurrence in patients with a resected T1-4N0-2M0 NSCLC. Further data on MVI prognostic impact should be collected for the next revision of the TNM staging system.

AB - Objective: We aimed to assess the prognostic significance of microscopic vessel invasion (MVI) and visceral pleural invasion (VPI) in non-small cell lung cancer (NSCLC). Background: VPI is included in the current tumor-node- metastasis (TNM) classification in NSCLC; however, MVI is not incorporated in TNM classification. Methods: From August 1992 to December 2009, 2657 consecutive patients with pathological T1-4N0-2M0 NSCLC underwent complete resection. In addition to conventional staging factors, we evaluated MVI histologically and analyzed its significance in NSCLC recurrence prognosis. The recurrence-free period in several NSCLC subgroups was analyzed using the Kaplan-Meier method and Cox regression analysis. Results: The proportion of patients with a 5-year recurrence-free period was 52.6% and 87.5%, respectively, in those with and without MVI (P < 0.001). Multivariate analysis showed that MVI, similarly to VPI, was found to be an independently significant predictor of recurrence [hazard ratio (HR): 2.78]. In particular, MVI and VPI were the 2 strongest significant independent predictors of recurrence in 1601 patients with pathological stage I disease treated without adjuvant chemotherapy (HR: 2.74 and 1.84, respectively). In each T subgroup analysis, evident and significant separation of the recurrence-free proportion curves were observed among the 3 groups (VPI and MVI absent, VPI or MVI present, and VPI and MVI present). Conclusions: This study demonstrated that MVI was a significant independent risk factor for recurrence in patients with a resected T1-4N0-2M0 NSCLC. Further data on MVI prognostic impact should be collected for the next revision of the TNM staging system.

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