Blood Vessel Invasion as a Strong Independent Prognostic Indicator in Non-Small Cell Lung Cancer: A Systematic Review and Meta-Analysis

Wang, Jun; Chen, Jianpeng; Chen, Xi; Wang, Baocheng; Li, Kainan; Bi, Jian

doi:10.1371/journal.pone.0028844

Cited by 47 publications

(38 citation statements)

References 73 publications

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“…The presence of vascular invasion by neoplastic cells indicates that the cancers are in a metastatic phase. Our previous meta-analysis found that LVI is a prognostic factor for survival in patients with NSCLC [8]. In the present study, we obtained summary statistics indicating that LVI status predicts poor survival in patients with NSCLC regardless of tumor size or lymph node status according to univariate or multivariate analysis.…”

Section: Discussionmentioning

confidence: 60%

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Clinical Significance and Role of Lymphatic Vessel Invasion as a Major Prognostic Implication in Non-Small Cell Lung Cancer: A Meta-Analysis

Wang

Zhao

et al. 2012

PLoS ONE

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BackgroundLymphatic vessel invasion (LVI) exerts an important process in the progression and local spread of cancer cells. However, LVI as a prognostic factor for survival in non-small cell lung cancer (NSCLC) remains controversial.Methodology/Principal FindingsA meta-analysis of published studies from PubMed and EMBASE electronic databases was performed to quantity the effects of LVI on both relapse-free survival and overall survival for patients with NSCLC. Hazard ratios (HRs) with 95% confidence intervals (95% CIs) were used to assess the strength of these effects. This meta-analysis included 18,442 NSCLC patients from 53 eligible studies. LVI appeared in 32.1% (median; range, 2.8% to 70.9%) of tumor samples. In all, patients with LVI were 2.48 times more likely to relapse by univariate analysis (95% CI: 1.92–3.22) and 1.73 times by multivariate analysis (95% CI: 1.24–2.41) compared with those without LVI. For the analyses of LVI and overall survival, the pooled HR estimate was 1.97 (95% CI: 1.75–2.21) by univariate analysis and 1.59 (95% CI: 1.41–1.79) by multivariate analysis. Multivariate analysis showed a risk was 91% higher for recurrence (HR = 1.91, 95% CI: 1.14–2.91) and 70% higher for mortality (HR = 1.70, 95% CI: 1.38–2.10) in LVI-positive I stage patients compared with LVI-negative I stage patients. Subgroup analyses showed similar significant adjusted risks for recurrence and death in adenocarcinomas, and a significant adjusted risk for death in studies that utilized elastic staining with or without immunohistochemistry in defining LVI.Conclusions/SignificanceThe present study indicates that LVI appears to be an independent poor prognosticator in surgically managed NSCLC. NSCLC patients with LVI would require a more aggressive treatment strategy after surgery. However, large, well-designed prospective studies with clinically relevant modeling and standard methodology to assess LVI are required to address some of these important issues.

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Section: Discussionmentioning

confidence: 60%

“…Blood vessel invasion (BVI) also exerts an important influence on patient outcome. The relative risk of recurrence and death for an individual patient whose tumor showed BVI by tumor cells was nearly 4 and 2 times higher, respectively, than that of a patient whose tumor did not show BVI by tumor cells [8].…”

Section: Introductionmentioning

confidence: 82%

Clinical Significance and Role of Lymphatic Vessel Invasion as a Major Prognostic Implication in Non-Small Cell Lung Cancer: A Meta-Analysis

Wang

Zhao

et al. 2012

PLoS ONE

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“…Haemoglobin level (,12 g?dL -1 ) might be associated with a higher mortality and preoperative high Cyfra 21-1 level has been associated with higher risk of relapse [14]. Blood vessel invasion is associated to an increased risk of relapse and death as shown by a meta-analysis (multivariate combined hazard ratio for relapse free survival 3.98 (95% CI 2.24-7.06) and for survival 1.90 (95% CI 1.65-2.19)) [15].…”

Section: Classical Host-related and Tumour-related Factorsmentioning

confidence: 96%

Prognostic and predictive factors for lung cancer

Paesmans

2012

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“…In fact, studies have shown that good clinical outcomes are limited to lung cancer patients who are diagnosed before blood vessel invasion and before the disease metastasizes to the regional lymph nodes or has locally advanced (3,4). For this reason, much effort has focused on improving the rates of early diagnosis through improved imaging technology and adaption of screening programs.…”

Section: Introductionmentioning

confidence: 99%

Prognostic and predictive biomarkers post curative intent therapy

Feldman¹,

Kim²

2017

Ann. Transl. Med.

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Large-scale screening trials have demonstrated that early diagnosis of lung cancer results in a significant reduction in lung cancer mortality. Despite improvements in detecting more lung cancers at early stages, the 5-year survival rates of lung cancers diagnosed before widespread disease is only 30-50%.High rates of recurrence, despite early diagnosis, suggest the need to improve treatment strategies based on the likelihood of recurrence in patient subsets, as well as explore the role of predictive markers for therapy selection in the adjuvant setting. In the era of personalized medicine, there have been a wide array of molecular alterations and signatures studied for their potential prognostic and predictive utility, however most have failed to translate into clinical tools. This review will discuss progress made in clinical management of lung cancer, and recent progress in the development of patient selection tools for the refinement of early stage lung cancers.

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Blood Vessel Invasion as a Strong Independent Prognostic Indicator in Non-Small Cell Lung Cancer: A Systematic Review and Meta-Analysis

Cited by 47 publications

References 73 publications

Clinical Significance and Role of Lymphatic Vessel Invasion as a Major Prognostic Implication in Non-Small Cell Lung Cancer: A Meta-Analysis

Clinical Significance and Role of Lymphatic Vessel Invasion as a Major Prognostic Implication in Non-Small Cell Lung Cancer: A Meta-Analysis

Prognostic and predictive factors for lung cancer

Prognostic and predictive biomarkers post curative intent therapy

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