Significance of the Presence of Microscopic Vascular Invasion After Complete Resection of Stage I–II pT1-T2N0 Non-small Cell Lung Cancer and Its Relation with T-Size Categories: Did the 2009 7th Edition of the TNM Staging System Miss Something?

Ruffini, Enrico; Asioli, Sofia; Filosso, Pier Luigi; Buffoni, L; Bruna, Maria Cristina; Mossetti, C; Solidoro, Paolo; Oliaro, A

doi:10.1097/jto.0b013e3182011f70

Cited by 63 publications

(40 citation statements)

References 31 publications

(42 reference statements)

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“…Although results correlating angioinvasion and a poor outcome in early stage lung cancer have been inconsistent [4,5] several recent pathological studies have identified a strong association [6][7][8][9]. The PI3K/mTOR pathway has been linked to invasion through the upregulation of MMP-9 in hepatocellular carcinoma [10].…”

Section: Introductionmentioning

confidence: 99%

Overexpression of the mammalian target of rapamycin (mTOR) and angioinvasion are poor prognostic factors in early stage NSCLC: A verification study

et al. 2012

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Section: Introductionmentioning

confidence: 99%

Overexpression of the mammalian target of rapamycin (mTOR) and angioinvasion are poor prognostic factors in early stage NSCLC: A verification study

et al. 2012

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“…Furthermore vascular invasion, along with other published studies [25][26][27][28], in our large series resulted as another strong independent prognostic factor. Although prospective studies are needed, our findings underline the importance of a careful evaluation of lymph nodes and vascular invasion in resected NSCLC as it may provide additional useful information for identifying patients who are at high risk and who may be candidates for further medical treatment after or before surgery.…”

Section: Discussionmentioning

confidence: 51%

“…The most complex and unsatisfactory aspect of the current TNM staging system in lung cancer is represented by the method of assessing nodal disease. In lung cancer the anatomic extent of lymph node metastasis defines pN categories [12,28]. This current nodal system, based only on the anatomic extent of metastatic lymph nodes, can result in different prognosis even in the same nodal stage, especially with mediastinal (N2) lymph node involvement.…”

Section: Discussionmentioning

confidence: 99%

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Prognostic Factors in Early Stage Non-Small Cell Lung Cancer: The Importance of Number of Resected Lymph Nodes and Vascular Invasion

Santinelli¹

2013

Chemotherapy

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Background: Despite an appropriate surgical treatment, half of early-stage non-small cell lung cancer patients will die due to lung cancer. The number of resected lymph-nodes and vascular invasion has proved to be a prognostic factor in other solid tumors, as well as breast and colorectal cancer. Here we evaluate their prognostic impact in the largest mono-centric series of resected non-small cell lung cancer patients. Methods:Clinical and pathological characteristics and prognostic outcomes of four hundred thirty-nine consecutive patients undergoing radical surgical resection for non-small cell lung cancer at our Institution were evaluated. Results:The multivariate analysis showed that number of resected lymph nodes, vascular invasion and sex had a prognostic impact on overall survival. The optimal cut-off number of lymph nodes with the highest sensitivity and specificity for estimating the outcome was set at ten after Receiver Operating Characteristics curve analysis. Removing ten lymph nodes in our study represents a cut-off with a significant prognostic impact particularly in resected stage II non-small cell lung cancer. Conclusions:Similarly to other cancer types (for example colorectal cancer), our results suggest that an adequate classification of non-small cell lung cancer should always include an adequate lymph nodes clearance, particularly in stage II non-small cell lung cancer. Again vascular invasion resulted independent prognostic factors for overall survival. Therefore the number of resected lymph nodes, together with vascular invasion, may also drive the selection of nonsmall cell lung cancer patients for adjuvant treatment. Lung cancer is one of more aggressive tumor. Lung tumor surgery with loco-regional lymphadenectomy represents the only way for the eradication of neoplastic disease. In particular, an adequate lymph nodes clearance, especially in stage II non-small cell lung cancer may modify prognosis.

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“…In a study conducted on lymphnode-negative early-stage patients that had been subject to resection, Naito et al established that MVI was observed to be an independent negative prognostic factor and found as a stronger prognostic indicator than T size, according to the 2009 TNM staging system [21]. Likewise Ruffini et al worked with patients diagnosed with NSCLC and operated in pT1-T2N0 stages and found that the presence of MVI was an independent negative prognostic factor [22]. However, Chandrachud et al found in a survival analysis performed on operated NSCLC patients that tumor volume was the only factor affecting survival, the authors identified vascular invasion not to be a determining value in prognosis [23].…”

Section: Discussionmentioning

confidence: 99%

Survival in Operated Early and Local Advanced-Stage (IA-IIIA) Non-Small Cell Lung Cancer

Taylan

Arınç²,

Misirlioglu³

et al. 2016

J Clin Exp Invest

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Objective: The early and local advanced stages (IA-IIIA) of non-small cell lung cancer (NSCLC) warrant the curative treatment approach of surgery. However, despite the surgical approach, survival depends on a number of factors. The aim of the study was to examine the factors that affect survival in operated NSCLC patients with these stages.Methods: A cohort of 231 operated patients with IA, IB, IIA, IIB, and IIIA stages of NSCLC were analyzed. The effects of age, sex, comorbidity, performance status, histopathology of the tumor, T stage, N stage, pleural invasion, surgical resection type and postoperative resection margin invasion on the survival of the patients were examined with KaplanMeier and Cox Regression analyses.Results: Advanced age (OR=1.042 for every passing year, CI=1.020-1.064), adenocarcinoma histopathology (OR=1.676 CI=1.178-2.384), N2 invasion (OR=2.389 CI=1.46-4.239), pleural invasion (OR=2.403 CI=1.569-3.678), resection margin invasion (OR=2.401, CI=1.141-5.048) and pneumonectomy as the type of surgical operation (OR=2.313, CI=1.467-3.647) were found to be independent prognostic factors of mortality. Conclusion:Follow-up of the NSCLC cases with advanced age, an adenocarcinoma type, visceral pleural invasion, N2-lymph node invasion, a history of pneumonectomy, and a resection margin invasion should be undertaken more attentively during planning of surgical operation and postoperative period. Sonuç: İleri yaştaki, adenokanser tipine sahip, viseral plevra invazyonu veya N2 tutulumu olan, pnömomonektomi operasyonu geçiren ve cerrahi sınırda tümör pozitifliği görülen opere erken ve lokal ileri evre KHDAK tanılı hastaların perioperatif ve postoperatif dönemdeki takipleri dikkatli planlanmalıdır.Anahtar kelimeler: sağkalım, mortalite, performans skoru, opere edilmiş, küçük hücreli olmayan akciğer kanseri Taylan M, et al. Survival in Operated Non-Small Cell Lung Cancer

show abstract

Significance of the Presence of Microscopic Vascular Invasion After Complete Resection of Stage I–II pT1-T2N0 Non-small Cell Lung Cancer and Its Relation with T-Size Categories: Did the 2009 7th Edition of the TNM Staging System Miss Something?

Cited by 63 publications

References 31 publications

Overexpression of the mammalian target of rapamycin (mTOR) and angioinvasion are poor prognostic factors in early stage NSCLC: A verification study

Overexpression of the mammalian target of rapamycin (mTOR) and angioinvasion are poor prognostic factors in early stage NSCLC: A verification study

Prognostic Factors in Early Stage Non-Small Cell Lung Cancer: The Importance of Number of Resected Lymph Nodes and Vascular Invasion

Survival in Operated Early and Local Advanced-Stage (IA-IIIA) Non-Small Cell Lung Cancer

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