Prognostic value of nonangiogenic and angiogenic growth patterns in non-small-cell lung cancer

• Published in: British journal of cancer Vol. 91; no. 7; pp. 1293 - 1300
• Main Authors: SARDARI NIA, P, COLPAERT, C, VAN SCHIL, P, BLYWEERT, B, KUI, B, VERMEULEN, P, FERGUSON, M, HENDRIKS, J, WEYLER, J, PEZZELLA, F, VAN MARCK, E
• Format: Journal Article
• Language: English
• Published: Basingstoke Nature Publishing Group 04.10.2004
• Subjects: Adult; Aged; Aged, 80 and over; Biological and medical sciences; Carcinoma, Non-Small-Cell Lung - blood supply; Carcinoma, Non-Small-Cell Lung - pathology; Disease-Free Survival; Female; Humans; Lung cancer; Lung Neoplasms - blood supply; Lung Neoplasms - pathology; Male; Medical sciences; Middle Aged; Molecular and Cellular Pathology; Neoplasm Staging - methods; Neovascularization, Pathologic; Pneumology; Prognosis; Regression Analysis; Retrospective Studies; Tumors; Tumors of the respiratory system and mediastinum; Lung disease; Prognosis; Respiratory disease; Lung cancer; growth pattern; Malignant tumor; non-small cell lung carcinoma; Survival; Angiogenesis; nonangiogenic growth; Cancerology; survival analysis; Bronchus disease; Neovascularization; non-small-cell lung cancer
• ISSN: 0007-0920; 1532-1827
• DOI: 10.1038/sj.bjc.6602134

An essential prerequisite of nonangiogenic growth appears to be the ability of the tumour to preserve the parenchymal structures of the host tissue. This morphological feature is visible on a routine tissue section. Based on this feature, we classified haematoxylin and eosin-stained tissue sections from 279 patients with non-small-cell lung cancer into three growth patterns: destructive (angiogenic; n=196), papillary (intermediate; n=38) and alveolar (nonangiogenic; n=45). A Cox multiple regression model was used to test the prognostic value of growth patterns together with other relevant clinicopathological factors. For overall survival, growth pattern (P=0.007), N-status (P=0.001), age (P=0.020) and type of operation (P=0.056) were independent prognostic factors. For disease-free survival, only growth pattern (P=0.007) and N-status (P<0.001) had an independent prognostic value. Alveolar (hazard ratio=1.825, 95% confidence interval=1.117-2.980, P=0.016) and papillary (hazard ratio=1.977, 95% confidence interval=1.169-3.345, P=0.011) growth patterns were independent predictors of poor prognosis. The proposed classification has an independent prognostic value for overall survival as well as for disease-free survival, providing a possible explanation for survival differences of patients in the same disease stage.