Blood vessel and lymphatic vessel invasion in resected nonsmall cell lung carcinoma: Correlation with TNM stage and disease free and overall survival

• Published in: Cancer Vol. 78; no. 10; pp. 2111 - 2118
• Main Authors: Bréchot, Jeanne‐Marie, Chevret, Sylvie, Charpentier, Marie‐Christine, de Vecchi, Corinne Appere, Capron, Frédérique, Prudent, Jacques, Rochemaure, Jacques, Chastang, Claude
• Format: Journal Article
• Language: English
• Published: New York Wiley Subscription Services, Inc., A Wiley Company 15.11.1996
• Subjects: Adenocarcinoma - mortality; Adenocarcinoma - pathology; Adenocarcinoma - surgery; Adult; Aged; Aged, 80 and over; blood vessel invasion; Blood Vessels - pathology; Carcinoma, Non-Small-Cell Lung - mortality; Carcinoma, Non-Small-Cell Lung - pathology; Carcinoma, Non-Small-Cell Lung - surgery; Carcinoma, Squamous Cell - mortality; Carcinoma, Squamous Cell - pathology; Carcinoma, Squamous Cell - surgery; Disease-Free Survival; Female; Humans; Lung - blood supply; Lung Neoplasms - mortality; Lung Neoplasms - pathology; Lung Neoplasms - surgery; Lymphatic System - pathology; lymphatic vessel invasion; Male; Middle Aged; Multivariate Analysis; Neoplasm Invasiveness; Neoplasm Staging; nonsmall cell lung carcinoma; Prognosis; Prospective Studies; survival; Survival Rate
• ISSN: 0008-543X; 1097-0142
• DOI: 10.1002/(SICI)1097-0142(19961115)78:10<2111::AID-CNCR11>3.0.CO;2-1

BACKGROUND The objective of this prospective study was to assess in 96 patients with resected nonsmall cell lung carcinoma (NSCLC) the prevalence of both blood and lymphatic vessel invasion (BVI and LVI) according to stage, as well as their prognostic value for disease free and overall survival. METHODS BVI and LVI were evaluated by hematoxylin and eosin stains on surgical specimens after resection. Associations among variables were tested by Fisher's exact test or the chi‐square test; prognostic values on time‐failure data were analyzed by the log rank test and the multivariate Cox model. RESULTS BVI was present in 52% of NSCLC cases and LVI in 59%. Venous but not arterial vascular invasion correlated with the T factor and pTNM, whereas LVI correlated with the N factor and pTNM. In univariate analysis, LVI but not BVI was associated with a short disease free interval (P = 0.0007) and poor survival (P = 0.0001). The estimated relative risk of death in patients with LVI was 3.2 compared with patients without LVI. In multivariate analysis, LVI and pTNM were additional predictors for poor disease free and overall survival. In this series, BVI had no prognostic value. CONCLUSIONS The prevalence of BVI and LVI appeared high in patients with NSCLC, especially those with advanced pTNM stages. LVI was predictive of poor outcome, both time to recurrence and death. Cancer 1996;78:2111‐8.