Kotaro Nomura1,2,3, Keiju Aokage2, Tokiko Nakai1, Shingo Sakashita1, Tomohiro Miyoshi2, Kenta Tane2, Joji Samejima2, Kenji Suzuki3, Masahiro Tsuboi2, Genichiro Ishii4,5. 1. Department of Pathology and Clinical Laboratories, National Cancer Center, 6-5-1, Kashiwanoha, Kashiwa, Chiba, 277-8577, Japan. 2. Department of Thoracic Surgery, National Cancer Center Hospital East, Kashiwa, Chiba, Japan. 3. Departments of General Thoracic Surgery, Juntendo University School of Medicine, Tokyo, Japan. 4. Department of Pathology and Clinical Laboratories, National Cancer Center, 6-5-1, Kashiwanoha, Kashiwa, Chiba, 277-8577, Japan. gishii@east.ncc.go.jp. 5. Division of Innovative Pathology and Laboratory Medicine, Exploratory Oncology Research and Clinical Trial Center, National Cancer Center East, Kashiwa, Chiba, Japan. gishii@east.ncc.go.jp.
Abstract
PURPOSE: Lymph node involvement is one of the important prognostic factors of patients with lung adenocarcinoma. In the tumor, node, and metastasis classification, lymph node involvement is categorized only according to the anatomical station and not the involvement pattern. The aim of this study was to investigate which morphological pattern of lymph node involvement affects the prognosis of patients with surgically resected lung adenocarcinoma. METHODS: We retrospectively reviewed 168 consecutive patients who underwent surgical resection for primary lung adenocarcinoma with lymph node involvement. The morphological patterns of lymph node involvement (tumor area, number of metastatic lymph nodes, presence of necrosis, and extranodal extension) were histologically examined. The relationships between the patterns of lymph node involvement, clinicopathological features, and survival of patients were analyzed. RESULTS: Eighty patients had N1 disease, and 88 patients had N2 disease. Univariate analysis revealed that invasive size, history of adjuvant chemotherapy, and presence of extranodal extension were significant prognostic factors in N1 patients, and vascular invasion, pleural invasion, presence of epidermal growth factor receptor mutation, history of adjuvant chemotherapy, and presence of extranodal extension were significant prognostic factors in N2 patients. In a bivariate analysis including other clinicopathological factors and patterns of lymph node involvement, the presence of extranodal extension was significantly associated with poor 3-year overall and recurrence-free survival of both N1 and N2 patients. CONCLUSIONS: In patients who underwent surgical resection for lung adenocarcinoma with lymph node involvement, the extranodal extension was the most important prognostic factor among morphological lymph node involvement patterns.
PURPOSE: Lymph node involvement is one of the important prognostic factors of patients with lung adenocarcinoma. In the tumor, node, and metastasis classification, lymph node involvement is categorized only according to the anatomical station and not the involvement pattern. The aim of this study was to investigate which morphological pattern of lymph node involvement affects the prognosis of patients with surgically resected lung adenocarcinoma. METHODS: We retrospectively reviewed 168 consecutive patients who underwent surgical resection for primary lung adenocarcinoma with lymph node involvement. The morphological patterns of lymph node involvement (tumor area, number of metastatic lymph nodes, presence of necrosis, and extranodal extension) were histologically examined. The relationships between the patterns of lymph node involvement, clinicopathological features, and survival of patients were analyzed. RESULTS: Eighty patients had N1 disease, and 88 patients had N2 disease. Univariate analysis revealed that invasive size, history of adjuvant chemotherapy, and presence of extranodal extension were significant prognostic factors in N1 patients, and vascular invasion, pleural invasion, presence of epidermal growth factor receptor mutation, history of adjuvant chemotherapy, and presence of extranodal extension were significant prognostic factors in N2 patients. In a bivariate analysis including other clinicopathological factors and patterns of lymph node involvement, the presence of extranodal extension was significantly associated with poor 3-year overall and recurrence-free survival of both N1 and N2 patients. CONCLUSIONS: In patients who underwent surgical resection for lung adenocarcinoma with lymph node involvement, the extranodal extension was the most important prognostic factor among morphological lymph node involvement patterns.
Authors: M Brown; F P Assen; A Leithner; J Abe; H Schachner; G Asfour; Z Bago-Horvath; J V Stein; P Uhrin; M Sixt; D Kerjaschki Journal: Science Date: 2018-03-23 Impact factor: 47.728
Authors: Hisao Asamura; Kari Chansky; John Crowley; Peter Goldstraw; Valerie W Rusch; Johan F Vansteenkiste; Hirokazu Watanabe; Yi-Long Wu; Marcin Zielinski; David Ball; Ramon Rami-Porta Journal: J Thorac Oncol Date: 2015-12 Impact factor: 15.609