Prognostic factors obtained by a pathologic examination in completely resected non-small-cell lung cancer: An analysis in each pathologic stage

Abstract

We attempted to clarify what factors predominantly influence the survival of patients with non-small-cell lung cancer in each pathologic stage on the basis of information generally obtained by a pathologic examination of completely resected non-small-cell lung cancer. The subjects included 243 patients with stage I, 63 with stage II, and 108 with stage IIIA disease. Pathologic features used in the analysis were as follows: the greatest tumor size (< or = 3.0 cm versus > 3.0 cm), the histologic cell type (squamous versus nonsquamous cell carcinoma), the grade of differentiation, and tumor invasion of pleura and vessels. In stage IIIA, the extent of the metastasis to the lymph nodes was also included in the analysis. The significant prognostic factors (p < 0.05) in stage I demonstrated by a univariate analysis of the survival curves included the tumor size, the grade of differentiation (well differentiated versus moderately and poorly differentiated tumor), pleural involvement, and invasion of the artery and vein. In addition, the histologic cell type and the pleural involvement in stage II and invasion of the vein and the extent of metastasis to the lymph nodes (N0 and N1 versus N2) in stage IIIA were also found to be significant prognostic factors. A multivariate prognostic factor analysis showed that the grade of differentiation, pleural involvement, and venous invasion in stage I; the histologic cell type and pleural involvement in stage II; and venous invasion and mediastinal lymph node metastasis in stage IIIA were all predominant prognostic factors. These observations therefore suggest that a pathologic examination can identify the patients with a poor prognosis, which is different among the stages.

The Diagnosis and Significance of Visceral Pleural Invasion in Lung Carcinoma: Histologic Predictors and the Role of Elastic Stains

“…In 2 large séries, pleural involvement was found to be independently significant by multivariate and univariate analysis in stage I disease 5 and stage I and II disease. 6 Similar findings were found by univariate analysis in NI disease 7 and by univariate but not by multivariate analysis in stage I disease. 4 One study found poorer survival in patients with pi lésions compared with selected control subjects with pO lésions in squamous cell carcinoma.…”

“…Some studies confirm viscéral pleural invasion as an independent prognostic indicator. [4][5][6][7][8] The AJCC Cancer Staging Manual does not offer detailed advice on the diagnosis of viscéral pleural invasion. 9 Others, however, hâve proposed a useful staging classification, 10 with the following types: pO, no viscéral pleural involvement; pi, pénétration through the viscéral pleura elastic tissue but not to the surface of the viscéral pleura; p2, pénétration through to the surface of the viscéral pleura; and p3, involvement of pariétal pleura.…”

Prognostic factors in resected pathological N1-stage II nonsmall cell lung cancer

“…However, the impact of any non-nodal factor is less clear than in stage I disease. HOLMES [30] reported significant survival differences favouring squamous cell lung cancer in T1N1 and ICHINOSE et al [31] showed similar results in T1-2N1 disease. However, neither MARTINI et al [32] nor YANO et al [8] found any significant histological benefit favouring squamous cell lung cancer over nonsquamous cell lung cancer.…”

Adenoviral Transduction ofMRP-1/CD9andKAI1/CD82Inhibits Lymph Node Metastasis in Orthotopic Lung Cancer Model

“…A previous study reported that nodal micrometastases were found in up to 36% of the resected lungs from the patients with peripheral NSCLC and the presence of metastases to the lymph nodes has been shown to immensely reduce the survival rates (26)(27)(28). Consequently, the development of a strategy to suppress lymphatic metastasis seems to be critical in the treatment of lung cancer patients.…”