Prognostic Significance of Lymphovascular Invasion for Patients with Stage I Non-Small Cell Lung Cancer

Abstract

Aims: This study retrospectively investigated the clinical significance of lymphovascular invasion (LVI) following a complete resection for stage I non-small cell lung cancer (NSCLC). Methods: A total of 226 patients who underwent a complete resection for pathological stage I NSCLC were examined. Results: Lymphatic invasion was pathologically diagnosed as ly0 in 156 patients, ly1 in 65, and ly2 in 5 patients. The pathological vascular invasion was diagnosed as v0 in 178 patients, v1 in 35, v2 in 10, and v3 in 3 patients. The 5-year survival rate after surgery of the patients with and without lymphatic invasion was 76.8 and 90.6%, respectively. There was a significantly more unfavorable prognosis in patients with lymphatic invasion (p = 0.042). The 5-year survival rate of the patients with vascular invasion was also significantly more unfavorable (67.8%) than that of patients without vascular invasion (90.4%; p = 0.004). LVI was found to significantly correlate with tumor size and the presence of pleural invasion. Conclusion: The LVI of NSCLC is a significant prognostic factor in patients with stage I tumors. In future clinical trials, it is necessary to evaluate the efficacy of adjuvant therapy for the selection of patients according to this criterion.

Clinical Significance and Role of Lymphatic Vessel Invasion as a Major Prognostic Implication in Non-Small Cell Lung Cancer: A Meta-Analysis

“…In multivariate analyses, 18 studies [20], [31], [37], [39], [41], [42], [47], [49], [51], [53], [55], [57], [58], [61], [64]–[67] were significant compared with 13 studies [19], [21], [27], [29], [34], [40], [44], [46], [48], [54], [63], [68], [69] with non-significant results. Of these included significant or non- significant studies, 3 have duplicated survival data [29], [37], [70] and one has uncompleted data [53].…”

“…Hanagiri et al . found that lymphatic vessels and blood vessels are widely interconnected in the peritumorous region as spreading routes for the cancer cells [40]. Some studies also indicate that peritumoral lymphangiogensis and LVI are more common compared with the intratumoral lymphatics [77], and are present in significantly higher percentage of cases with lymph node metastasis, as compared to those without lymph node metastasis [78].…”

Lymphatic invasion is a more significant prognostic factor than visceral pleural invasion in non‐small cell lung cancer with tumours of 3 cm or less

“…Some studies evaluated lymphatic invasion and vascular invasion separately . On the other hand, some studies evaluated lymphovascular invasion as one prognostic factor . In fact, lymphatic invasion and vascular invasion may not have the same effect on prognosis with lung cancer .…”

“…7,[14][15][16] On the other hand, some studies evaluated lymphovascular invasion as one prognostic factor. 8,10,17 In fact, lymphatic invasion and vascular invasion may not have the same effect on prognosis with lung cancer. 18 Furthermore, visceral pleural invasion, lymphatic invasion and vascular invasion may have different effects on the prognosis of early-stage lung cancer.…”

<p>Enlarged Mediastinal Lymph Nodes in Computed Tomography are a Valuable Prognostic Factor in Non-Small Cell Lung Cancer Patients with Pathologically Negative Lymph Nodes</p>

“…Some studies have focused on the clinical characteristic related to the LN enlargement, but the correlation between pathology and LN enlargement has been controversial. 19 – 21 Tsutani et al suggested that the size of the solid tumor was an independent predictor of nodal enlargement. 19 – 22 Still, the T staging did not correlate with LN enlargement in our data.…”