Visceral pleural invasion classification in non-small-cell lung cancer in the 7th edition of the tumor, node, metastasis classification for lung cancer: Validation analysis based on a large-scale nationwide database

Akikazu Kawase, Junji Yoshida, Etsuo Miyaoka, Hisao Asamura, Yoshitaka Fujii, Yoichi Nakanishi, Kenji Eguchi, Masaki Mori, Noriyoshi Sawabata, Meinoshin Okumura, Kohei Yokoi

Research output: Contribution to journalArticle

42 Citations (Scopus)

Abstract

OBJECTIVE: In the 7th tumor, node, metastasis (TNM) classification, visceral pleural invasion (VPI) is defined as invasion beyond the elastic layer, including invasion to the visceral pleural surface, and T1 tumors with VPI are upgraded to T2a. To validate this, we analyzed the survival of non-small-cell lung cancer patients from a nationwide database and evaluated the prognostic impact of VPI. METHODS: The clinicopathological characteristics and prognosis of 4995 patients who were included in the registry study of the Japanese Joint Committee of Lung Cancer Registry were retrospectively analyzed with a special interest in the prognostic impact of VPI. These patients underwent surgery in 2004 and were pathologically staged as T1a-3N0. VPI was defined as including PL1 and PL2 according to the 7th TNM Classification, but the Japanese Joint Committee of Lung Cancer Registry did not collect data regarding staining or how extensively VPI was evaluated in each participating institution. RESULTS: The survival differences were statistically significant between PL0 and PL1, PL1 and PL2, as well as PL2 and T3. There were no significant survival differences between T1a with VPI and T1b without VPI, or between T1a with VPI and T2a without VPI. There were no significant survival differences between T1b with VPI and T2a without VPI, or between T1b with VPI and T2b without VPI. There were no significant survival differences between T2a with VPI and T2b without VPI, or between T2b with VPI and T2b without VPI. T3 showed significantly worse prognosis than T2a with VPI and T2b with VPI. CONCLUSIONS: In addition to the current TNM classification recommendations, in which T1 tumors with VPI are upgraded to T2a, T2a tumors with VPI should be classified as T2b.

Original languageEnglish
Pages (from-to)606-611
Number of pages6
JournalJournal of Thoracic Oncology
Volume8
Issue number5
DOIs
Publication statusPublished - 2013 May
Externally publishedYes

Fingerprint

Non-Small Cell Lung Carcinoma
Lung Neoplasms
Databases
Neoplasm Metastasis
Survival
Registries
Neoplasms
Staining and Labeling

Keywords

  • NSCLC
  • TNM classification
  • visceral pleural invasion

ASJC Scopus subject areas

  • Oncology
  • Pulmonary and Respiratory Medicine

Cite this

Visceral pleural invasion classification in non-small-cell lung cancer in the 7th edition of the tumor, node, metastasis classification for lung cancer : Validation analysis based on a large-scale nationwide database. / Kawase, Akikazu; Yoshida, Junji; Miyaoka, Etsuo; Asamura, Hisao; Fujii, Yoshitaka; Nakanishi, Yoichi; Eguchi, Kenji; Mori, Masaki; Sawabata, Noriyoshi; Okumura, Meinoshin; Yokoi, Kohei.

In: Journal of Thoracic Oncology, Vol. 8, No. 5, 05.2013, p. 606-611.

Research output: Contribution to journalArticle

Kawase, Akikazu ; Yoshida, Junji ; Miyaoka, Etsuo ; Asamura, Hisao ; Fujii, Yoshitaka ; Nakanishi, Yoichi ; Eguchi, Kenji ; Mori, Masaki ; Sawabata, Noriyoshi ; Okumura, Meinoshin ; Yokoi, Kohei. / Visceral pleural invasion classification in non-small-cell lung cancer in the 7th edition of the tumor, node, metastasis classification for lung cancer : Validation analysis based on a large-scale nationwide database. In: Journal of Thoracic Oncology. 2013 ; Vol. 8, No. 5. pp. 606-611.
@article{7eccb799fa7c42f28225a5bd584b0763,
title = "Visceral pleural invasion classification in non-small-cell lung cancer in the 7th edition of the tumor, node, metastasis classification for lung cancer: Validation analysis based on a large-scale nationwide database",
abstract = "OBJECTIVE: In the 7th tumor, node, metastasis (TNM) classification, visceral pleural invasion (VPI) is defined as invasion beyond the elastic layer, including invasion to the visceral pleural surface, and T1 tumors with VPI are upgraded to T2a. To validate this, we analyzed the survival of non-small-cell lung cancer patients from a nationwide database and evaluated the prognostic impact of VPI. METHODS: The clinicopathological characteristics and prognosis of 4995 patients who were included in the registry study of the Japanese Joint Committee of Lung Cancer Registry were retrospectively analyzed with a special interest in the prognostic impact of VPI. These patients underwent surgery in 2004 and were pathologically staged as T1a-3N0. VPI was defined as including PL1 and PL2 according to the 7th TNM Classification, but the Japanese Joint Committee of Lung Cancer Registry did not collect data regarding staining or how extensively VPI was evaluated in each participating institution. RESULTS: The survival differences were statistically significant between PL0 and PL1, PL1 and PL2, as well as PL2 and T3. There were no significant survival differences between T1a with VPI and T1b without VPI, or between T1a with VPI and T2a without VPI. There were no significant survival differences between T1b with VPI and T2a without VPI, or between T1b with VPI and T2b without VPI. There were no significant survival differences between T2a with VPI and T2b without VPI, or between T2b with VPI and T2b without VPI. T3 showed significantly worse prognosis than T2a with VPI and T2b with VPI. CONCLUSIONS: In addition to the current TNM classification recommendations, in which T1 tumors with VPI are upgraded to T2a, T2a tumors with VPI should be classified as T2b.",
keywords = "NSCLC, TNM classification, visceral pleural invasion",
author = "Akikazu Kawase and Junji Yoshida and Etsuo Miyaoka and Hisao Asamura and Yoshitaka Fujii and Yoichi Nakanishi and Kenji Eguchi and Masaki Mori and Noriyoshi Sawabata and Meinoshin Okumura and Kohei Yokoi",
year = "2013",
month = "5",
doi = "10.1097/JTO.0b013e31828632b8",
language = "English",
volume = "8",
pages = "606--611",
journal = "Journal of Thoracic Oncology",
issn = "1556-0864",
publisher = "International Association for the Study of Lung Cancer",
number = "5",

}

TY - JOUR

T1 - Visceral pleural invasion classification in non-small-cell lung cancer in the 7th edition of the tumor, node, metastasis classification for lung cancer

T2 - Validation analysis based on a large-scale nationwide database

AU - Kawase, Akikazu

AU - Yoshida, Junji

AU - Miyaoka, Etsuo

AU - Asamura, Hisao

AU - Fujii, Yoshitaka

AU - Nakanishi, Yoichi

AU - Eguchi, Kenji

AU - Mori, Masaki

AU - Sawabata, Noriyoshi

AU - Okumura, Meinoshin

AU - Yokoi, Kohei

PY - 2013/5

Y1 - 2013/5

N2 - OBJECTIVE: In the 7th tumor, node, metastasis (TNM) classification, visceral pleural invasion (VPI) is defined as invasion beyond the elastic layer, including invasion to the visceral pleural surface, and T1 tumors with VPI are upgraded to T2a. To validate this, we analyzed the survival of non-small-cell lung cancer patients from a nationwide database and evaluated the prognostic impact of VPI. METHODS: The clinicopathological characteristics and prognosis of 4995 patients who were included in the registry study of the Japanese Joint Committee of Lung Cancer Registry were retrospectively analyzed with a special interest in the prognostic impact of VPI. These patients underwent surgery in 2004 and were pathologically staged as T1a-3N0. VPI was defined as including PL1 and PL2 according to the 7th TNM Classification, but the Japanese Joint Committee of Lung Cancer Registry did not collect data regarding staining or how extensively VPI was evaluated in each participating institution. RESULTS: The survival differences were statistically significant between PL0 and PL1, PL1 and PL2, as well as PL2 and T3. There were no significant survival differences between T1a with VPI and T1b without VPI, or between T1a with VPI and T2a without VPI. There were no significant survival differences between T1b with VPI and T2a without VPI, or between T1b with VPI and T2b without VPI. There were no significant survival differences between T2a with VPI and T2b without VPI, or between T2b with VPI and T2b without VPI. T3 showed significantly worse prognosis than T2a with VPI and T2b with VPI. CONCLUSIONS: In addition to the current TNM classification recommendations, in which T1 tumors with VPI are upgraded to T2a, T2a tumors with VPI should be classified as T2b.

AB - OBJECTIVE: In the 7th tumor, node, metastasis (TNM) classification, visceral pleural invasion (VPI) is defined as invasion beyond the elastic layer, including invasion to the visceral pleural surface, and T1 tumors with VPI are upgraded to T2a. To validate this, we analyzed the survival of non-small-cell lung cancer patients from a nationwide database and evaluated the prognostic impact of VPI. METHODS: The clinicopathological characteristics and prognosis of 4995 patients who were included in the registry study of the Japanese Joint Committee of Lung Cancer Registry were retrospectively analyzed with a special interest in the prognostic impact of VPI. These patients underwent surgery in 2004 and were pathologically staged as T1a-3N0. VPI was defined as including PL1 and PL2 according to the 7th TNM Classification, but the Japanese Joint Committee of Lung Cancer Registry did not collect data regarding staining or how extensively VPI was evaluated in each participating institution. RESULTS: The survival differences were statistically significant between PL0 and PL1, PL1 and PL2, as well as PL2 and T3. There were no significant survival differences between T1a with VPI and T1b without VPI, or between T1a with VPI and T2a without VPI. There were no significant survival differences between T1b with VPI and T2a without VPI, or between T1b with VPI and T2b without VPI. There were no significant survival differences between T2a with VPI and T2b without VPI, or between T2b with VPI and T2b without VPI. T3 showed significantly worse prognosis than T2a with VPI and T2b with VPI. CONCLUSIONS: In addition to the current TNM classification recommendations, in which T1 tumors with VPI are upgraded to T2a, T2a tumors with VPI should be classified as T2b.

KW - NSCLC

KW - TNM classification

KW - visceral pleural invasion

UR - http://www.scopus.com/inward/record.url?scp=84876411677&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84876411677&partnerID=8YFLogxK

U2 - 10.1097/JTO.0b013e31828632b8

DO - 10.1097/JTO.0b013e31828632b8

M3 - Article

C2 - 23478542

AN - SCOPUS:84876411677

VL - 8

SP - 606

EP - 611

JO - Journal of Thoracic Oncology

JF - Journal of Thoracic Oncology

SN - 1556-0864

IS - 5

ER -