Prognostic value of nonangiogenic and angiogenic growth patterns in non-small-cell lung cancer

Abstract

An essential prerequisite of nonangiogenic growth appears to be the ability of the tumour to preserve the parenchymal structures of the host tissue. This morphological feature is visible on a routine tissue section. Based on this feature, we classified haematoxylin and eosin-stained tissue sections from 279 patients with non-small-cell lung cancer into three growth patterns: destructive (angiogenic; n ¼ 196), papillary (intermediate; n ¼ 38) and alveolar (nonangiogenic; n ¼ 45). A Cox multiple regression model was used to test the prognostic value of growth patterns together with other relevant clinicopathological factors. For overall survival, growth pattern (P ¼ 0.007), N-status (P ¼ 0.001), age (P ¼ 0.020) and type of operation (P ¼ 0.056) were independent prognostic factors. For disease-free survival, only growth pattern (P ¼ 0.007) and N-status (Po0.001) had an independent prognostic value. Alveolar (hazard ratio ¼ 1.825, 95% confidence interval ¼ 1.117 -2.980, P ¼ 0.016) and papillary (hazard ratio ¼ 1.977, 95% confidence interval ¼ 1.169 -3.345, P ¼ 0.011) growth patterns were independent predictors of poor prognosis. The proposed classification has an independent prognostic value for overall survival as well as for disease-free survival, providing a possible explanation for survival differences of patients in the same disease stage.

The histological growth pattern of colorectal cancer liver metastases has prognostic value

“…These findings are in contrast to data in (primary) non small cell lung cancer. Our group demonstrated before that in these lung carcinomas a non-angiogenic alveolar GP or a lowangiogenic papillary GP is an independent predictor of poor prognosis [11,12]. To what extent PT characteristics, the metastatic process itself and characteristics of the host organ are responsible for the observed differences in GP and in concurrent tumour aggressiveness remains to be elucidated.…”

“…Although it is not clear how to correlate these characteristics of computed tomography images to the histological findings, one could hypothesize that the shape relates to the histological GP. In primary lung cancer tumours with an alveolar GP, which have comparable growth characteristics to the replacement GP of CRC liver metastases [10], indeed have a shorter disease-free and overall survival [11,12].…”

3-Dimensional Patient-Derived Lung Cancer Assays Reveal Resistance to Standards-of-Care Promoted by Stromal Cells but Sensitivity to Histone Deacetylase Inhibitors

“…Of 36 successfully engrafted NSCLC tumors, 94% of the corresponding original patient tumor displayed a destructive (angiogenic) growth pattern (29,30), with destruction of the normal lung parenchyma and infiltration with tumor-associated stroma ( Fig. 1).…”

The morphological growth patterns of colorectal liver metastases are prognostic for overall survival

“…3 Correlations between low-angiogenic growth patterns and poor survival have also been reported for primary non-small-cell lung cancer. 14,15 In addition to this, hypothetically, the intercellular interactions between tumor cells and hepatocytes in the replacement pattern (see Figure 1d) may exert tumor-promoting properties. It should be emphasized that the intermediate survival rates for patients with pushing-and mixed-type metastases could reflect heterogeneity within these two groups with both highly aggressive and more indolent tumors represented.…”