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

Wang, Jun; Wang, Baocheng; Zhao, Weipeng; Guo, Yan; Chen, Hong; Chu, Huili; Liang, Xue; Bi, Jian

doi:10.1371/journal.pone.0052704

Cited by 26 publications

(21 citation statements)

References 77 publications

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“…12,13) Various factors such as age, sex, smoking habit, ethnicity, tumor size, SUVmax, visceral pleural invasion, lymphatic invasion, and venous invasion have been reported to predict survival in surgical cases of NSCLC. [14][15][16][17][18][19][20][21][22][23][24][25] However, only a few reports have analyzed AD and SQ separately. In the present study, the most powerful prognostic factors for RFS and OS in AD were histologic pleural invasion.…”

Section: Discussionmentioning

confidence: 99%

Difference in Postsurgical Prognostic Factors between Lung Adenocarcinoma and Squamous Cell Carcinoma

Nakamura

Sakai

Kimura

et al. 2017

ATCS

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IntroductionLung adenocarcinoma (AD) and squamous cell carcinoma (SQ) are the two major histologic types of nonsmall-cell lung cancer (NSCLC), and have been considered to be almost similar in both postsurgical prognosis and chemotherapeutic responses for a long period of time. However, recent multiple studies on the postsurgical outcomes of these two histologic types Difference in Postsurgical Prognostic Factors between Lung Adenocarcinoma and Squamous Cell CarcinomaHaruhiko Nakamura, MD, PhD, Hiroki Sakai, MD, Hiroyuki Kimura, MD, Tomoyuki Miyazawa, MD, Hideki Marushima, MD, PhD, and Hisashi Saji, MD, PhD Purpose: The aim of this study was to compare the clinicopathologic prognostic factors between patients who underwent lung resection for adenocarcinoma (AD) and those with squamous cell carcinoma (SQ). Methods: A database of patients with lung AD or SQ who underwent surgery with curative intent in our department from January 2008 to December 2014 was reviewed. Associations between various clinicopathologic factors, postsurgical recurrence-free survival (RFS), and overall survival (OS) were analyzed to find significant prognostic factors. Results: A total of 537 lung cancer patients (AD, 434; SQ, 103) were included in this study. Although RFS was similar in patients with AD and SQ, OS was significantly poorer in those with SQ. Multivariate analysis in patients with AD revealed that age (≥69 vs. <69), lymphatic invasion, and histologic pleural invasion (p0 vs. p1-3) were associated with RFS, while gender and pleural invasion were associated with OS. In SQ, however, smoking, clinical stage, and pulmonary metastasis were associated with RFS in the multivariate analysis. Conclusion: Since significant postoperative prognostic factors are quite different between lung AD and SQ, these two histologic types should be differently analyzed in a clinical study.

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Section: Discussionmentioning

confidence: 99%

Difference in Postsurgical Prognostic Factors between Lung Adenocarcinoma and Squamous Cell Carcinoma

Nakamura

Sakai

Kimura

et al. 2017

ATCS

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“…Currently, the tumor, node, metastasis (TNM) staging system, based on the tumor characteristics, regional lymph nodes, and potential metastatic sites, is a widely accepted prognostic tool for NSCLC patients [ 3 ]. Other clinical and pathologic factors used to predict disease progression include patient age at diagnosis and tumor nuclear grade, histologic type, lymphovascular invasion, visceral pleural invasion, and margin status [ 4 , 5 ]. Some molecular markers have been associated with survival [ 6 ].…”

Section: Introductionmentioning

confidence: 99%

Pretreatment Neutrophil to Lymphocyte Ratio Is Associated with Poor Survival in Patients with Stage I-III Non-Small Cell Lung Cancer

Wang

Kalhor

et al. 2016

PLoS ONE

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BackgroundNeutrophil-to-lymphocyte ratio (NLR) has been shown to be a prognostic indicator in several types of cancer. We aimed to investigate the association between NLR and survival in surgery-treated non-small cell lung cancer (NSCLC) patients.Study DesignThis large retrospective study included 1,245 patients who underwent initial surgery for stage I–III NSCLC at The University of Texas MD Anderson Cancer Center between December 2002 and November 2010. We analyzed the relationship of NLR with clinicopathological variables, local recurrence-free survival (LRFS), distant recurrence-free survival (DRFS), recurrence-free survival (RFS), overall survival (OS), and disease-specific survival (DSS) in patients with high or low NLR using Kaplan-Meier method. Hazard ratios (HRs) with 95% confidence intervals (CIs) were used to assess the prognostic strength of NLR.ResultsThere was a statistically significant association between the pretreatment NLR and histology type (P = 0.003) and tumor grade (P = 0.028). At a median follow-up time of 50.6 months, high NLR was associated with reduced DRFS (P = 0.011), OS (P < 0.0001) and DSS (P = 0.004); it was not associated with LRFS and RFS. Multivariable Cox analysis further revealed that NLR (P = 0.027), pathologic stage (P < 0.0001) and lymphovascular invasion (P < 0.0001) were strong independent predictors for DRFS. NLR was also an independent marker predicting poor OS (P = 0.002) and DSS (P = 0.017).ConclusionThe pretreatment NLR can serve as a biomarker to predict distant recurrence and death in stage I–III NSCLC patients. Combination of NLR and pathologic stage can better predict the OS and DSS in stage I-II NSCLC patients.

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“…Others have reported vascular invasion to be an independent prognostic factor in NSCLC . As early as in 1960, Mosely and Dickson found venous invasion to be associated with reduced survival .…”

Section: Discussionmentioning

confidence: 99%

Vascular invasion is an adverse prognostic factor in resected non–small‐cell lung cancer

Ramnefjell

Aamelfot

Helgeland

et al. 2017

APMIS

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Lung cancer is a leading cause of death, and there is a need for better prognostic factors in treatment decisions. Vascular invasion is a known negative prognosticator, but it is not clear how to evaluate this feature. Here, we studied the prevalence and prognostic impact of blood and lymphatic vascular invasion (BVI, LVI), tumour grade, necrosis, inflammation and pleural invasion on cancer-specific survival (LCSS) and time to recurrence (TTR) in non-small-cell lung cancer (NSCLC). A total of 438 patients surgically treated for NSCLC (1993-2010) were examined, including 213 adenocarcinomas (AC), 135 squamous cell carcinomas (SCC) and 90 other NSCLC. BVI and LVI were found in 25% and 21% of the cases, with reduced LCSS and TTR for both markers in AC and SCC (p < 0.005 for all). BVI and LVI remained independent prognostic factors for LCSS and TTR in separate multivariate models for AC and SCC. Combined BVI/LVI (7%) showed significantly reduced LCSS and TTR (p < 0.001), also by multivariate analysis. Our results support that BVI and LVI are valuable for prognostic staging. Vascular invasion identifies a group of patients at higher risk of recurrence and lung cancer-related death, and this could influence stratification of patients for treatment and follow-up.

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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

Cited by 26 publications

References 77 publications

Difference in Postsurgical Prognostic Factors between Lung Adenocarcinoma and Squamous Cell Carcinoma

Difference in Postsurgical Prognostic Factors between Lung Adenocarcinoma and Squamous Cell Carcinoma

Pretreatment Neutrophil to Lymphocyte Ratio Is Associated with Poor Survival in Patients with Stage I-III Non-Small Cell Lung Cancer

Vascular invasion is an adverse prognostic factor in resected non–small‐cell lung cancer

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