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

Seok, Yangki; Jeong, Ji Yun; Lee, Eungbae

doi:10.1111/1759-7714.12424

Cited by 14 publications

(8 citation statements)

References 18 publications

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“…However, their study had several limitations, including a limited number of patients who underwent sublobectomy, relatively few outcome events, and a short follow-up due to their data being extracted from the SEER program (2017 update). In contrast to their study, data on the extent of VPI (PL1 and PL2) were not collected in our study for the survival analysis because data were not available before 2010 in the SEER database; however, several studies have confirmed that the extent of VPI may not influence survival outcomes in patients with completely resected NSCLC with VPI (11,23,24). Moon et al (12) studied the surgical outcomes of 89 NSCLC patients with VPI (N=38) or lymphovascular invasion (N=71) and showed that the OS rate did not differ significantly by the surgical extent (P=0.615), and sublobar resection was not an independent risk factor according to the multivariate analysis.…”

Section: Discussionmentioning

confidence: 94%

Sublobectomy versus lobectomy for long-term survival outcomes of early-stage non-small cell lung cancer with a tumor size ≤2 cm accompanied by visceral pleural invasion: a SEER population-based study

Huang

Wang

et al. 2020

J Thorac Dis

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Background: The optimal surgical strategy for early-stage non-small cell lung cancer (NSCLC) with visceral pleural invasion (VPI) remains unclear. Due to limited prospective comparative data for these surgical modalities, the objective of the current study was to compare the long-term survival outcomes of sublobectomy (Sub) versus lobectomy (Lob) for NSCLC with a tumor size ≤2 cm and VPI. Methods: Patients with early-stage NSCLC characterized by VPI diagnosed between 2004 and 2013 were identified from the Surveillance, Epidemiology, and End Results (SEER) program. The baseline demographic and cancer characteristics, treatment information as well as survival outcome data were extracted from the SEER database, and confounders were balanced by propensity score matching (PSM) and inverse probability of treatment weighting (IPTW) analyses. Lung disease-specific survival (DSS) and overall survival (OS) rates were compared with Cox proportional hazards (PH) regression models based on the unmatched cohort, the propensity-based matched cohort, and the IPTW cohort. Results: Of the 1,386 patients enrolled, 1,000 (72.15%) and 386 (27.85%) underwent lobectomy and sublobectomy, respectively. The 5-year DSS rate was 78.64% for the lobectomy group and 59.47% for the sublobectomy group. Cox regression models demonstrated that the operation type (Sub vs. Lob) was an independent prognostic factor for early-stage NSCLC with VPI based on the three different cohorts.Patients who underwent lobectomy showed better long-term DSS and OS rates than those treated with sublobectomy after PSM [DSS: hazard ratio (HR) 0.689, 95% confidence interval (CI): 0.490-0.968, P=0.032; OS: HR 0.723, 95% CI: 0.549-0.953, P=0.021]. The IPTW analysis yielded similar results. Conclusions: Lobectomy showed superior long-term survival compared with sublobectomy in patients with early-stage NSCLC with a tumor size ≤2 cm and VPI.

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Section: Discussionmentioning

confidence: 94%

Sublobectomy versus lobectomy for long-term survival outcomes of early-stage non-small cell lung cancer with a tumor size ≤2 cm accompanied by visceral pleural invasion: a SEER population-based study

Huang

Wang

et al. 2020

J Thorac Dis

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“…Second, we did not classify VPI as PL1 or PL2. Pleural invasion can be classified into four groups: PL0, PL1, PL2, and PL3 ( 20 ). Among them, PL1 and PL2 are considered VPI in the current TNM staging system.…”

Section: Discussionmentioning

confidence: 99%

Impact of adjuvant chemotherapy on patients with stage IB non-small cell lung cancer with visceral pleural invasion

Kim,

Choi,

Lee

et al. 2024

J Thorac Dis

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Background Adjuvant chemotherapy has reduced the risk of recurrence and death in stage IB non-small cell lung cancer (NSCLC) with high-risk factors; however, the impact of visceral pleural invasion (VPI) on outcomes in stage IB NSCLC treated with adjuvant chemotherapy remains controversial. The aim of this study was to explore the clinical and prognostic significance of adjuvant chemotherapy for stage IB (1–4 cm) NSCLC with VPI. Methods This retrospective study included 251 patients admitted between January 2008 and May 2018 from four hospitals who underwent complete resection for Tumor-Node-Metastasis (TNM) 8th edition stage IB NSCLC with VPI. The relationship between adjuvant chemotherapy and overall survival (OS) or recurrence-free survival (RFS) was analyzed using the Kaplan-Meier method and Cox proportional hazards model. Results Of 251 patients with stage IB NSCLC with VPI, 122 (48.6%) received adjuvant chemotherapy after surgical resection and 129 (51.4%) were placed under observation. Multivariable analysis showed that adjuvant chemotherapy was an independent predictor of RFS [adjusted hazard ratio (aHR), 0.57; 95% confidence interval (CI): 0.33–0.96; P=0.036]. A micropapillary pattern (aHR, 2.46; 95% CI: 1.33–4.55; P=0.004) and lymphovascular invasion (aHR, 2.86; 95% CI: 1.49–5.48; P=0.002) were associated with a higher risk of recurrence. Multivariable analysis also showed that adjuvant chemotherapy was an independent predictor of OS (aHR, 0.22; 95% CI: 0.09–0.58; P=0.002). In a subgroup analysis of patients with a tumor size of 1–3 cm, adjuvant chemotherapy was associated with improved RFS and OS, and this association was maintained even when patients with VPI had additional risk factors. Conclusions Our study shows that adjuvant chemotherapy is appropriate for patients with stage IB (1–4 cm) NSCLC with VPI, and even those with smaller tumors (1–3 cm).

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“…One study indicated that VPI does not significantly impact OS in patients with early-stage NSCLC (106). Building upon this finding, Seok et al (107) conducted a retrospective study in 2017, examining the survival of 90 patients with N0 NSCLC and concurrent VPI. Ultimately, they concluded that the extent of VPI may not affect the prognosis of N0 NSCLC patients who undergo surgical resection with VPI.…”

Section: Visceral Pleural Invasion and Prognosis And Survivalmentioning

confidence: 99%

Diagnosis, treatment, and prognosis of stage IB non-small cell lung cancer with visceral pleural invasion

Ruan,

Zhuo,

2024

Front. Oncol.

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With the increasing implementation of early lung cancer screening and the increasing emphasis on physical examinations, the early-stage lung cancer detection rate continues to rise. Visceral pleural invasion (VPI), which denotes the tumor’s breach of the elastic layer or reaching the surface of the visceral pleura, stands as a pivotal factor that impacts the prognosis of patients with non-small cell lung cancer (NSCLC) and directly influences the pathological staging of early-stage cases. According to the latest 9th edition of the TNM staging system for NSCLC, even when the tumor diameter is less than 3 cm, the final T stage remains T2a if VPI is present. There is considerable controversy within the guidelines regarding treatment options for stage IB NSCLC, especially among patients exhibiting VPI. Moreover, the precise determination of VPI is important in guiding treatment selection and prognostic evaluation in individuals with NSCLC. This article aims to provide a comprehensive review of the current status and advancements in studies pertaining to stage IB NSCLC accompanied by VPI.

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

Cited by 14 publications

References 18 publications

Sublobectomy versus lobectomy for long-term survival outcomes of early-stage non-small cell lung cancer with a tumor size ≤2 cm accompanied by visceral pleural invasion: a SEER population-based study

Sublobectomy versus lobectomy for long-term survival outcomes of early-stage non-small cell lung cancer with a tumor size ≤2 cm accompanied by visceral pleural invasion: a SEER population-based study

Impact of adjuvant chemotherapy on patients with stage IB non-small cell lung cancer with visceral pleural invasion

Diagnosis, treatment, and prognosis of stage IB non-small cell lung cancer with visceral pleural invasion

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