Prognostic impact of preoperative tumor marker levels and lymphovascular invasion in pathological stage I adenocarcinoma and squamous cell carcinoma of the lung

Tomonari Kinoshita, Takashi Ohtsuka, Masaya Yotsukura, Keisuke Asakura, Taichiro Goto, Ikuo Kamiyama, Sotaro Otake, Atsushi Tajima, Katsura Emoto, Yuichiro Hayashi, Mitsutomo Kohno

Research output: Contribution to journalArticle

10 Citations (Scopus)

Abstract

INTRODUCTION:: Some unfavorable prognostic factors for stage I non-small cell lung cancers have been reported; however, they are not reflected in the current TNM classification.

METHODS:: We retrospectively reviewed 629 patients who underwent complete resection of pathological stage I adenocarcinomas (ADs) or squamous cell carcinomas (SQs) at two institutes between 1996 and 2011. The correlation between clinicopathological characteristics and survival rates was analyzed to identify prognostic factors.

RESULTS:: Multivariate analysis indicated that among ADs, high serum carcinoembryonic antigen (CEA) levels [P = 0.04 for overall survival (OS); P < 0.01 for recurrence-free survival (RFS); P = 0.02 for disease-specific survival (DSS)], lymphatic permeation (P < 0.01 for RFS and DSS), and vascular invasion (P < 0.01 for OS and RFS; P = 0.03 for DSS) were independent prognostic factors. Among SQs, high squamous cell carcinoma (SCC) antigen (P < 0.05 for OS), and vascular invasion (P < 0.05 for RFS and DSS) were independently prognostic. We suggest that among completely resected tumors ≤5 cm without lymph node metastasis, the current stages IA and IB AD with high serum CEA levels, lymphatic permeation, or vascular invasion should be upgraded to stage IB and IIA, respectively. The current stage IA SQ with high SCC antigen levels or vascular invasion should be upgraded to stage IB. These reclassifications accurately reflect survival status (P < 0.04 in all comparisons).

CONCLUSIONS:: Some important differences in prognostic factors were observed between AD and SQ. High preoperative serum tumor marker levels and lymphovascular invasion should be included as additional criteria in the forthcoming TNM staging.

Original languageEnglish
JournalJournal of Thoracic Oncology
DOIs
Publication statusAccepted/In press - 2015 Jan 28

Fingerprint

Tumor Biomarkers
Squamous Cell Carcinoma
Adenocarcinoma
Lung
Survival
Blood Vessels
Recurrence
Neoplasm Staging
Carcinoembryonic Antigen
Disease-Free Survival
Serum
Non-Small Cell Lung Carcinoma
Multivariate Analysis
Survival Rate
Biomarkers
Lymph Nodes
Neoplasm Metastasis

ASJC Scopus subject areas

  • Oncology
  • Pulmonary and Respiratory Medicine

Cite this

Prognostic impact of preoperative tumor marker levels and lymphovascular invasion in pathological stage I adenocarcinoma and squamous cell carcinoma of the lung. / Kinoshita, Tomonari; Ohtsuka, Takashi; Yotsukura, Masaya; Asakura, Keisuke; Goto, Taichiro; Kamiyama, Ikuo; Otake, Sotaro; Tajima, Atsushi; Emoto, Katsura; Hayashi, Yuichiro; Kohno, Mitsutomo.

In: Journal of Thoracic Oncology, 28.01.2015.

Research output: Contribution to journalArticle

Kinoshita, Tomonari ; Ohtsuka, Takashi ; Yotsukura, Masaya ; Asakura, Keisuke ; Goto, Taichiro ; Kamiyama, Ikuo ; Otake, Sotaro ; Tajima, Atsushi ; Emoto, Katsura ; Hayashi, Yuichiro ; Kohno, Mitsutomo. / Prognostic impact of preoperative tumor marker levels and lymphovascular invasion in pathological stage I adenocarcinoma and squamous cell carcinoma of the lung. In: Journal of Thoracic Oncology. 2015.
@article{f51e7c5828684de49ee53723bb22d052,
title = "Prognostic impact of preoperative tumor marker levels and lymphovascular invasion in pathological stage I adenocarcinoma and squamous cell carcinoma of the lung",
abstract = "INTRODUCTION:: Some unfavorable prognostic factors for stage I non-small cell lung cancers have been reported; however, they are not reflected in the current TNM classification.METHODS:: We retrospectively reviewed 629 patients who underwent complete resection of pathological stage I adenocarcinomas (ADs) or squamous cell carcinomas (SQs) at two institutes between 1996 and 2011. The correlation between clinicopathological characteristics and survival rates was analyzed to identify prognostic factors.RESULTS:: Multivariate analysis indicated that among ADs, high serum carcinoembryonic antigen (CEA) levels [P = 0.04 for overall survival (OS); P < 0.01 for recurrence-free survival (RFS); P = 0.02 for disease-specific survival (DSS)], lymphatic permeation (P < 0.01 for RFS and DSS), and vascular invasion (P < 0.01 for OS and RFS; P = 0.03 for DSS) were independent prognostic factors. Among SQs, high squamous cell carcinoma (SCC) antigen (P < 0.05 for OS), and vascular invasion (P < 0.05 for RFS and DSS) were independently prognostic. We suggest that among completely resected tumors ≤5 cm without lymph node metastasis, the current stages IA and IB AD with high serum CEA levels, lymphatic permeation, or vascular invasion should be upgraded to stage IB and IIA, respectively. The current stage IA SQ with high SCC antigen levels or vascular invasion should be upgraded to stage IB. These reclassifications accurately reflect survival status (P < 0.04 in all comparisons).CONCLUSIONS:: Some important differences in prognostic factors were observed between AD and SQ. High preoperative serum tumor marker levels and lymphovascular invasion should be included as additional criteria in the forthcoming TNM staging.",
author = "Tomonari Kinoshita and Takashi Ohtsuka and Masaya Yotsukura and Keisuke Asakura and Taichiro Goto and Ikuo Kamiyama and Sotaro Otake and Atsushi Tajima and Katsura Emoto and Yuichiro Hayashi and Mitsutomo Kohno",
year = "2015",
month = "1",
day = "28",
doi = "10.1097/JTO.0000000000000480",
language = "English",
journal = "Journal of Thoracic Oncology",
issn = "1556-0864",
publisher = "International Association for the Study of Lung Cancer",

}

TY - JOUR

T1 - Prognostic impact of preoperative tumor marker levels and lymphovascular invasion in pathological stage I adenocarcinoma and squamous cell carcinoma of the lung

AU - Kinoshita, Tomonari

AU - Ohtsuka, Takashi

AU - Yotsukura, Masaya

AU - Asakura, Keisuke

AU - Goto, Taichiro

AU - Kamiyama, Ikuo

AU - Otake, Sotaro

AU - Tajima, Atsushi

AU - Emoto, Katsura

AU - Hayashi, Yuichiro

AU - Kohno, Mitsutomo

PY - 2015/1/28

Y1 - 2015/1/28

N2 - INTRODUCTION:: Some unfavorable prognostic factors for stage I non-small cell lung cancers have been reported; however, they are not reflected in the current TNM classification.METHODS:: We retrospectively reviewed 629 patients who underwent complete resection of pathological stage I adenocarcinomas (ADs) or squamous cell carcinomas (SQs) at two institutes between 1996 and 2011. The correlation between clinicopathological characteristics and survival rates was analyzed to identify prognostic factors.RESULTS:: Multivariate analysis indicated that among ADs, high serum carcinoembryonic antigen (CEA) levels [P = 0.04 for overall survival (OS); P < 0.01 for recurrence-free survival (RFS); P = 0.02 for disease-specific survival (DSS)], lymphatic permeation (P < 0.01 for RFS and DSS), and vascular invasion (P < 0.01 for OS and RFS; P = 0.03 for DSS) were independent prognostic factors. Among SQs, high squamous cell carcinoma (SCC) antigen (P < 0.05 for OS), and vascular invasion (P < 0.05 for RFS and DSS) were independently prognostic. We suggest that among completely resected tumors ≤5 cm without lymph node metastasis, the current stages IA and IB AD with high serum CEA levels, lymphatic permeation, or vascular invasion should be upgraded to stage IB and IIA, respectively. The current stage IA SQ with high SCC antigen levels or vascular invasion should be upgraded to stage IB. These reclassifications accurately reflect survival status (P < 0.04 in all comparisons).CONCLUSIONS:: Some important differences in prognostic factors were observed between AD and SQ. High preoperative serum tumor marker levels and lymphovascular invasion should be included as additional criteria in the forthcoming TNM staging.

AB - INTRODUCTION:: Some unfavorable prognostic factors for stage I non-small cell lung cancers have been reported; however, they are not reflected in the current TNM classification.METHODS:: We retrospectively reviewed 629 patients who underwent complete resection of pathological stage I adenocarcinomas (ADs) or squamous cell carcinomas (SQs) at two institutes between 1996 and 2011. The correlation between clinicopathological characteristics and survival rates was analyzed to identify prognostic factors.RESULTS:: Multivariate analysis indicated that among ADs, high serum carcinoembryonic antigen (CEA) levels [P = 0.04 for overall survival (OS); P < 0.01 for recurrence-free survival (RFS); P = 0.02 for disease-specific survival (DSS)], lymphatic permeation (P < 0.01 for RFS and DSS), and vascular invasion (P < 0.01 for OS and RFS; P = 0.03 for DSS) were independent prognostic factors. Among SQs, high squamous cell carcinoma (SCC) antigen (P < 0.05 for OS), and vascular invasion (P < 0.05 for RFS and DSS) were independently prognostic. We suggest that among completely resected tumors ≤5 cm without lymph node metastasis, the current stages IA and IB AD with high serum CEA levels, lymphatic permeation, or vascular invasion should be upgraded to stage IB and IIA, respectively. The current stage IA SQ with high SCC antigen levels or vascular invasion should be upgraded to stage IB. These reclassifications accurately reflect survival status (P < 0.04 in all comparisons).CONCLUSIONS:: Some important differences in prognostic factors were observed between AD and SQ. High preoperative serum tumor marker levels and lymphovascular invasion should be included as additional criteria in the forthcoming TNM staging.

UR - http://www.scopus.com/inward/record.url?scp=84922237646&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84922237646&partnerID=8YFLogxK

U2 - 10.1097/JTO.0000000000000480

DO - 10.1097/JTO.0000000000000480

M3 - Article

JO - Journal of Thoracic Oncology

JF - Journal of Thoracic Oncology

SN - 1556-0864

ER -