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Vascular invasion is an adverse prognostic factor in resected non–small‐cell lung cancer
Author(s) -
Ramnefjell Maria,
Aamelfot Christina,
Helgeland Lars,
Akslen Lars A.
Publication year - 2017
Publication title -
apmis
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.909
H-Index - 88
eISSN - 1600-0463
pISSN - 0903-4641
DOI - 10.1111/apm.12652
Subject(s) - lymphovascular invasion , lung cancer , medicine , adenocarcinoma , oncology , cancer , multivariate analysis , lung , pathology , gastroenterology , metastasis
Lung cancer is a leading cause of death, and there is a need for better prognostic factors in treatment decisions. Vascular invasion is a known negative prognosticator, but it is not clear how to evaluate this feature. Here, we studied the prevalence and prognostic impact of blood and lymphatic vascular invasion ( BVI , LVI ), tumour grade, necrosis, inflammation and pleural invasion on cancer‐specific survival ( LCSS ) and time to recurrence ( TTR ) in non–small‐cell lung cancer ( NSCLC ). A total of 438 patients surgically treated for NSCLC (1993–2010) were examined, including 213 adenocarcinomas ( AC ), 135 squamous cell carcinomas ( SCC ) and 90 other NSCLC . BVI and LVI were found in 25% and 21% of the cases, with reduced LCSS and TTR for both markers in AC and SCC (p < 0.005 for all). BVI and LVI remained independent prognostic factors for LCSS and TTR in separate multivariate models for AC and SCC . Combined BVI / LVI (7%) showed significantly reduced LCSS and TTR (p < 0.001), also by multivariate analysis. Our results support that BVI and LVI are valuable for prognostic staging. Vascular invasion identifies a group of patients at higher risk of recurrence and lung cancer–related death, and this could influence stratification of patients for treatment and follow‐up.