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Background  Visceral pleural invasion ( VPI ) is generally considered a poor prognostic factor in non‐small cell lung cancer ( NSCLC ).  VPI  is defined as penetration beyond the elastic layer of visceral pleura ( PL 1), including the visceral pleural surface without the involvement of adjacent structures ( PL 2) by cancer cells. The aim of this study was to evaluate the influence of the extent of  VPI  on  NSCLC  prognosis.    Methods  This was a retrospective study of 90 patients with resected node‐negative  NSCLC  with  VPI . The overall survival ( OS ) and disease‐free survival ( DFS ) rates were estimated using the  K aplan– M eier  m ethod. Multivariate analysis for prognostic factors was performed using a  C ox proportional hazards regression model. The pattern of recurrence was also compared between  PL 1 and  PL 2 groups.    Results  Seventy‐three patients had  PL 1. The three‐year  OS  rates for the  PL 1 and  PL 2 groups were 97.4% and 82.4%, respectively (  P   = 0.004). The two‐year  DFS  rates for  PL 1 and  PL 2 groups were 81.0% and 76.5%, respectively (  P   = 0.419). According to the multivariate analysis,  PL 2 was not a significant prognostic factor for survival outcome in node‐negative  NSCLC  with  VPI  compared to  PL 1 (hazard ratio for  DFS  1.753, 95% confidence interval 0.582–5.284;   P   = 0.319). In this study, six patients in the  PL 1 and one in  PL 2 group developed ipsilateral pleural recurrence (  P   = 1.000).    Conclusion   VPI  extent may not influence survival outcomes in patients with surgically resected node‐negative  NSCLC  with  VPI .

Extent of visceral pleural invasion and the prognosis of surgically resected node‐negative non‐small cell lung cancer