Prognostic Factors in Resected T3 Non-Small Cell Lung Carcinoma: Perineural Invasion as a New Prognostic Factor

Demir, Adalet; Günlüoğlu, Mehmet Zeki; Kara, H. Volkan; Büyükpınarbaşılı, Nur; Dinçer, Seyyit İbrahim

doi:10.1055/s-2007-965059

Cited by 9 publications

(6 citation statements)

References 14 publications

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“…In the present study, the rate of occurrence of major complications was 7.0 % (empyema, chylothorax, and postoperative bleeding), and the postoperative mortality rate was 2.3 %. According to most of previous studies, N1 or N2 disease was a significant unfavorable prognostic factor in comparison with T3N0M0 disease [8,9,[18][19][20][21][22][23]. However, in the present study, no difference in the prognosis was observed between patients with and without lymph node metastasis, likely because there were a too few patients with lymph node metastasis.…”

Section: Discussioncontrasting

confidence: 62%

Clinical Characteristics of Resected T3 Non-small Cell Lung Cancer Characterized by Parietal Pleural Invasion or Chest Wall Invasion

et al. 2012

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Section: Discussioncontrasting

confidence: 62%

Clinical Characteristics of Resected T3 Non-small Cell Lung Cancer Characterized by Parietal Pleural Invasion or Chest Wall Invasion

et al. 2012

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“…The presence of cancer cells in the perineurium is mostly associated with poor prognosis and high recurrence in pancreatic, colorectal, and gastric cancers, but not in invasive breast carcinoma (12). Highly contradictory results have been reported on the "inherent positive neuronal tropism" of lung cancer and the prognostic value of the perineural invasion in the lungs (13,14). The involvement of the PNS in the formation of distant lung cancer metastases has not been studied.…”

Section: Introductionmentioning

confidence: 99%

Schwann Cells Augment Cell Spreading and Metastasis of Lung Cancer

et al. 2018

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Although lungs are densely innervated by the peripheral nervous system (PNS), the role of the PNS in the progression of lung cancer is unknown. In this study, we report that mouse adult Schwann cells (SC), the principal glial cells of the PNS, can regulate the motility of lung cancer cells and the formation of metastases SCs promoted epithelial-to-mesenchymal transition (EMT) and the motility of two lung cancer cell lines by increasing expression of Snail and Twist in tumor cells; blocking of Snail and Twist expression abolished SC-induced motility of tumor cells. SC-derived CXCL5 was responsible for EMT in lung cancer cells, as the inhibition of CXCL5 or its receptor CXCR2 reduced SC-induced expression of Snail and Twist and reduced motility in tumor cells. CXCL5/CXCR2 binding activated the PI3K/AKT/GSK-3β/Snail-Twist signaling pathway in lung cancer cells, and the PI3K inhibitor blocked CXCL5-dependent phosphorylation of AKT and GSK-3β, reduced expression of Snail/Twist, and limited tumor cell invasiveness. SC conditioning of tumor cells prior to their injection into mice significantly increased the formation of metastases in the regional lymph nodes. In summary, SCs can regulate the CXCL5/CXCR2/PI3K/AKT/GSK-3β/Snail-Twist pathway to promote EMT, invasiveness, and metastatic potential of lung cancer cells. Our results reveal a new role of the PNS in the functional organization of the tumor microenvironment and tumor progression. This study increases our understanding of how nerves and, in particular, specific glial cells, Schwann cells, in the peripheral nervous system, may help promote tumor growth and metastasis. .

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“…The predictive effect of lymphovascular invasion on local–regional failure [ 19 ] and distant recurrence [ 26 , 27 ] has been demonstrated before. Visceral pleural invasion [ 19 , 22 ] and perineural invasion [ 20 , 21 ] are also considered prognostic factors of poor PFS. Our results suggest that pathological features are critical and recognizing patients with higher risk of recurrence might facilitate the selection of adjuvant systemic treatments.…”

Section: Discussionmentioning

confidence: 99%

“…Tissue slides stained with the hematoxylin–eosin stain, immunohistochemistry stain, or elastic stain were reviewed by experienced pathologists. The presence of tumor cells in the lymphatic or vascular lumen, the space around nerves, or the visceral pleura was defined as lymphovascular invasion [ 19 ], perineural invasion [ 20 , 21 ], or visceral pleural invasion [ 22 ], respectively. Margin involvement was defined as microscopic residual disease at the resection margin.…”

Section: Methodsmentioning

confidence: 99%

A real-world study comparing perioperative chemotherapy and EGFR-tyrosine kinase inhibitors for treatment of resected stage III EGFR-mutant adenocarcinoma

Chen,

Wang,

Liao

et al. 2023

BMC Cancer

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Background The patient population with stage III non-small-cell lung cancer (NSCLC) is heterogeneous, with varying staging characteristics and diverse treatment options. Despite the potential practice-changing implications of randomized controlled trials evaluating the efficacy of perioperative epidermal growth factor receptor-tyrosine kinase inhibitors (EGFR-TKIs), concerns have been raised due to conflicting overall survival (OS) results. Few real-world studies have examined the survival outcomes of patients with resected EGFR-mutant stage III adenocarcinoma receiving perioperative chemotherapy and EGFR–TKIs. Methods In this retrospective observational study, we enrolled patients with resected stage III adenocarcinoma with EGFR mutations between January 2011 and December 2021. Patients were classified into two groups: perioperative chemotherapy and perioperative EGFR–TKIs. Outcomes and prognostic factors were analyzed using Cox proportional hazards regression analysis. Results Eighty-four patients were enrolled in the analysis. Perioperative EGFR-TKIs led to longer progression-free survival (PFS) than chemotherapy (38.6 versus 14.2 months; p = 0.019). However, only pathological risk factors predicted poor PFS in multivariate analysis. Patients receiving perioperative chemotherapy had longer OS than those receiving EGFR-TKIs (111.3 versus 50.2 months; p = 0.052). Multivariate analysis identified perioperative treatment with EGFR-TKIs as an independent predictor of poor OS (HR: 3.76; 95% CI: 1.22–11.54). Conclusion Our study demonstrates that chemotherapy should be considered in the perioperative setting for high-risk patients, when taking pathological risk factors into consideration, and that optimized sequencing of EGFR–TKIs might be the most critical determinant of OS.

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Prognostic Factors in Resected T3 Non-Small Cell Lung Carcinoma: Perineural Invasion as a New Prognostic Factor

Cited by 9 publications

References 14 publications

Clinical Characteristics of Resected T3 Non-small Cell Lung Cancer Characterized by Parietal Pleural Invasion or Chest Wall Invasion

Clinical Characteristics of Resected T3 Non-small Cell Lung Cancer Characterized by Parietal Pleural Invasion or Chest Wall Invasion

Schwann Cells Augment Cell Spreading and Metastasis of Lung Cancer

A real-world study comparing perioperative chemotherapy and EGFR-tyrosine kinase inhibitors for treatment of resected stage III EGFR-mutant adenocarcinoma

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