Yusuke Sugita1,2, Tomonari Kinoshita3,4, Toshiyuki Shima1,5, Naomichi Sasaki1, Mao Uematsu1, Reiko Shimizu1, Masahiko Harada1, Tsunekazu Hishima6, Hirotoshi Horio1. 1. Department of Thoracic Surgery, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, 3-18-22, Honkomagome, Bunkyo-ku, Tokyo, 113-8677, Japan. 2. Department of Thoracic Surgery, Tokyo Medical and Dental University, Medical Hospital, Tokyo, 113-8519, Japan. 3. Department of Thoracic Surgery, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, 3-18-22, Honkomagome, Bunkyo-ku, Tokyo, 113-8677, Japan. kinotomo0415@gmail.com. 4. Division of Thoracic Surgery, Keio University School of Medicine, Tokyo, 160-8682, Japan. kinotomo0415@gmail.com. 5. Division of Thoracic Surgery, Keio University School of Medicine, Tokyo, 160-8682, Japan. 6. Department of Pathology, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, Tokyo, 113-8677, Japan.
Abstract
OBJECTIVE: Lymphatic permeation (LY) and vascular invasion (VI) are well-known as postoperative prognostic factors in non-small cell lung cancer (NSCLC). Some reports use the term "lymphovascular invasion (LVI)" in reference to the integration of LY and VI. The purpose in this study is to elucidate whether NSCLC with LY or VI can be labeled as LVI-positive NSCLC or it should be treated as an LY- or VI-positive tumor, respectively. METHODS: We reviewed 601 completely resected lung adenocarcinomas and squamous cell carcinomas, and examined the respective prognostic and biological significance of LY and VI. RESULTS: Among 454 adenocarcinomas, multivariate survival analyses showed that LY and VI were unfavorable prognostic factors in stages II and III and stages I and II, respectively. Conversely, this relationship was not found among 147 squamous cell carcinomas. Patients with adenocarcinomas with LY and VI had a significantly worse prognosis than those with adenocarcinomas with LY or VI in stage II, but not in stage I. Among 149 recurrent adenocarcinomas, only VI had a strong effect on early recurrence and shorter post-recurrence survival. LY and VI were predictors for multiple organ recurrence of adenocarcinoma. The recurrence of adenocarcinoma with LY was high in the ipsilateral mediastinal lymph nodes, whereas VI was significantly correlated with distant metastasis to organs, such as the brain, liver, and adrenal gland. CONCLUSIONS: LY and VI have differing effects postoperative prognosis and recurrence-relevant events, suggesting that these pathological findings should not be integrated as LVI.
OBJECTIVE: Lymphatic permeation (LY) and vascular invasion (VI) are well-known as postoperative prognostic factors in non-small cell lung cancer (NSCLC). Some reports use the term "lymphovascular invasion (LVI)" in reference to the integration of LY and VI. The purpose in this study is to elucidate whether NSCLC with LY or VI can be labeled as LVI-positive NSCLC or it should be treated as an LY- or VI-positive tumor, respectively. METHODS: We reviewed 601 completely resected lung adenocarcinomas and squamous cell carcinomas, and examined the respective prognostic and biological significance of LY and VI. RESULTS: Among 454 adenocarcinomas, multivariate survival analyses showed that LY and VI were unfavorable prognostic factors in stages II and III and stages I and II, respectively. Conversely, this relationship was not found among 147 squamous cell carcinomas. Patients with adenocarcinomas with LY and VI had a significantly worse prognosis than those with adenocarcinomas with LY or VI in stage II, but not in stage I. Among 149 recurrent adenocarcinomas, only VI had a strong effect on early recurrence and shorter post-recurrence survival. LY and VI were predictors for multiple organ recurrence of adenocarcinoma. The recurrence of adenocarcinoma with LY was high in the ipsilateral mediastinal lymph nodes, whereas VI was significantly correlated with distant metastasis to organs, such as the brain, liver, and adrenal gland. CONCLUSIONS: LY and VI have differing effects postoperative prognosis and recurrence-relevant events, suggesting that these pathological findings should not be integrated as LVI.
Authors: Melanie Biesinger; Nele Eicken; Alexander Varga; Michael Weber; Milos Brndiar; Georg Erd; Peter Errhalt; Klaus Hackner; Sarah Hintermair; Alexander Petter-Puchner; Axel Scheed; Elisabeth Stubenberger; Bahil Ghanim Journal: Cancers (Basel) Date: 2022-04-08 Impact factor: 6.575