Lymphovascular Invasion Increases the Risk of Nodal and Distant Recurrence in Node-Negative Stage I–IIA Non-Small-Cell Lung Cancer

Sung, Soo-Yoon; Kwak, Yoo-Kang; Lee, Sea-Won; Jo, In Young; Park, Jae Kil; Kim, Kyung Soo; Lee, Kyo Young; Kim, Yeon‐Sil

doi:10.1159/000488859

Cited by 28 publications

(16 citation statements)

References 23 publications

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“…The status of vascular invasion was associated with a greater tendency for lymph node metastases, with the highest ORs (3.88, P < 0.0001) in univariate and multivariate logistic analyses. The same conclusion was reached in the study of Sung et al Analysis of the reason might be that the worse the tumor differentiation is, the stronger the invasiveness would be, which leads to early metastasis. The status of vascular invasion suggests that tumor cells invade and migrate along surrounding tiny blood vessels or lymphatic vessels, which might cause early metastasis and poor prognosis.…”

Section: Discussionsupporting

confidence: 68%

Lymph node metastasis in Chinese patients with clinical T1 non‐small cell lung cancer: A multicenter real‐world observational study

Chen

Xiao-jun

et al. 2019

Thoracic Cancer

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Background Approximately 8.3–15.9% of patients with clinical stage I non‐small cell lung cancer are subsequently shown to have lymph node metastasis. However, the clinical characteristics of patients with lymph node metastasis in China are not fully understood. Methods This is a multicenter retrospective analysis of pathological T1 non‐small cell lung cancer patients who underwent surgical resection from 2 January 2014 to 27 December 2017. Clinical and pathological information was collected with the assistance of the Large‐scale Data Analysis Center of Cancer Precision Medicine‐LinkDoc database. The clinical and pathological factors associated with lymph node metastasis were analyzed by univariate and multivariate logistic regression. Results A total of 10 885 participants (51.6% women; 15.3% squamous cell carcinoma) were included in the analysis. The median age was 60.0 years (range 12.9–86.6 years). A total of 1159 patients (10.6%) had metastases in mediastinal nodes (N2), and 640 patients (5.9%) had metastasis in pulmonary lymph nodes (N1). Most patients had T1b lung cancer (4766, 43.8%). Of the patients, 3260 (29.9%) were current or former smokers. The univariate and multivariate analyses showed that younger age, squamous cell carcinoma, poor differentiation, larger tumor size, carcinoembryonic antigen level ≥5 ng/mL, and vascular invasion (+) were significantly associated with higher percentages of lymph node metastases ( P < 0.001 for all). Conclusion This real‐world study showed the significant association of lymph node metastasis with age, tumor size, histology and differentiation, carcinoembryonic antigen levels, and status of vascular invasion. Female patients with T1a adenocarcinoma in the right upper lobe barely had lymph node metastasis.

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Section: Discussionsupporting

confidence: 68%

Lymph node metastasis in Chinese patients with clinical T1 non‐small cell lung cancer: A multicenter real‐world observational study

Chen

Xiao-jun

et al. 2019

Thoracic Cancer

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“…Therefore, we recommended that complete dissection both of the lobar lymph node in TBL and NTBL be performed to improve the local control of patients with NSCLC. This suggestion is also supported by previous studies in patients with early stage NSCLC that have suggested similar risk factors for nodal and distant recurrence such as LVI in stage I [ 32 ] or tumor size, tumor differentiation, pleural invasion and bronchus invasion in stage I-IIA [ 33 ] so that complete lymph node dissection should be considered.…”

Section: Discussionsupporting

confidence: 78%

Risk factors of lobar lymph node metastases in non-primary tumor-bearing lobes among the patients of non-small-cell lung cancer

Liu

Lin

et al. 2020

PLoS ONE

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Purpose Lobar lymph node metastases in non-primary tumor-bearing lobes (NTBL) are rarely reported. This study examined the risk factors of lobar lymph node metastasis in NTBL. Methods We retrospectively studied 301 patients with non-small-cell lung cancer (NSCLC) who underwent surgical pulmonary resection with systematic lymph node dissection plus extended lobar lymph node dissection of NTBL. Patients were classified into positive and negative NTBL groups. Unconditional logistic regression was used to identify the risk factors for lobar lymph node metastasis in NTBL. Results NTBL lobar lymph nodes were identified in 38 patients (12.6%). A higher proportion of adenocarcinomas occurred in the positive NTBL group compared to the negative NTBL group (73.7% vs. 46.4%, P = 0.01). Risk of NTBL lobar lymph node metastases was significantly elevated in the lower lobe of primary site compared to the upper lobe (OR = 2.61, 95% CI = 1.26–5.75, P = 0.01), and with adenocarcinomas compared to squamous cell carcinomas (OR = 2.75, 95% CI = 1.09–7.65, P = 0.04). No differences were observed when comparing left and right lobes. NTBL lobar lymph node metastasis was most often observed among patients with larger tumor size, N1/N2 nodal involvement, with lymph vascular invasion (LVI), and visceral pleural invasion (VPI). Conclusion NTBL lobar lymph node metastases occurred more often in patients with a primary NSCLC tumor in the lower lobe, with adenocarcinomas, larger tumor size, N1/N2 nodal involvement, LVI or VPI. Extended lymphadenectomy including NTBL nodes may be clinically advantageous when these risk factors are present.

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“…LVI is known to be an important prognostic factor for postoperative recurrence and poor prognosis in patients with other cancers [ 21 22 23 ]. Lymphatic invasion was a negative prognostic factor independent of tumor stage in patients with thoracic esophageal squamous cell carcinoma, and lymphatic invasion was a risk factor for lymph node metastasis in T1 tumors and a high risk factor of recurrence in patients without lymph node involvement [ 21 ].…”

Section: Discussionmentioning

confidence: 99%

“…Lymphatic invasion was a negative prognostic factor independent of tumor stage in patients with thoracic esophageal squamous cell carcinoma, and lymphatic invasion was a risk factor for lymph node metastasis in T1 tumors and a high risk factor of recurrence in patients without lymph node involvement [ 21 ]. LVI was a negative prognostic factor in patients with stage I or IIA non-small cell lung cancer [ 22 ]. Yuan et al [ 23 ] analyzed the impact of LVI in stage I/II colorectal cancer, and showed that LVI is significantly associated with poor OS and RFS.…”

Section: Discussionmentioning

confidence: 99%

Prognostic Factors in Stage IB Gastric Cancer after Surgical Resection

Park

et al. 2020

J Gastric Cancer

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Purpose: The standard treatment for stage IB gastric cancer is curative surgery alone, but some patients show poor survival with disease recurrence after curative surgery. The aim of this study was to identify prognostic factors of recurrence and long-term survival in patients with stage IB gastric cancer after surgery. Materials and Methods: We retrospectively reviewed data from 253 patients with stage IB gastric cancer who underwent gastrectomy between 2011 and 2016 at Kyungpook National University Chilgok Hospital and analyzed the clinicopathological characteristics associated with recurrence and survival. Results: Fourteen patients experienced recurrence with a mean follow-up of 54.1 months. Two of these patients had locoregional recurrence and 12 patients had systemic recurrence. The median interval between the operation day and the day of recurrence was 11 months (range 4-56 months). Multivariate analysis revealed that lymphatic vessel invasion (LVI) (hazard ratio [HR], 3.851; 95% confidence interval [CI], 1.264-11.732) and the elderly (age≥65) (HR, 3.850; 95% CI, 1.157-12.809) were independent risk factors for recurrence after surgery. The LVI (HR, 3.630; 95% CI, 1.105-11.923) was the independent prognostic factors for disease-specific survival (DSS). The 5-year DSS rates were 96.8% in patients who did not have LVI, and 89.3% in patients who had LVI. Conclusions: This study shows that LVI was associated with recurrence and poor survival in patients with stage IB gastric cancer after curative gastrectomy. Patients diagnosed with LVI require careful attention for systemic recurrence during the follow-up period.

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Lymphovascular Invasion Increases the Risk of Nodal and Distant Recurrence in Node-Negative Stage I–IIA Non-Small-Cell Lung Cancer

Cited by 28 publications

References 23 publications

Lymph node metastasis in Chinese patients with clinical T1 non‐small cell lung cancer: A multicenter real‐world observational study

Lymph node metastasis in Chinese patients with clinical T1 non‐small cell lung cancer: A multicenter real‐world observational study

Risk factors of lobar lymph node metastases in non-primary tumor-bearing lobes among the patients of non-small-cell lung cancer

Prognostic Factors in Stage IB Gastric Cancer after Surgical Resection

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