The prognostic significance of histopathologic angioinvasion in stage I non-small cell lung cancer

Background: We aimed to analyze the prognostic significance of vascular invasion, which is one of the histopathological features affecting the prognosis in early stage lung cancers. Methods: Forty early stage (T1-2N0M0) non-small cell lung cancer patients (32 males, 8 females; mean age 53.8 +/- 8.7 years;, range 35 to 69 years) who underwent curative surgery with mediastinal lymph node dissection between December 1997 and January 2004 were retrospectively evaluated. Tumor histology, grade, vascular invasion, and the extent of resections were evaluated. Pathological slides were re-examined and invasion of at least two vascular structures and/or presence of tumoral thrombosis in the lumen of vessels were defined as vascular invasion. Results: Three-year disease free survival was found to be 67.2 +/- 7.5% and five-year survival was 64.5 +/- 7.6%. When an evaluation was done considering whether there was vascular invasion or not, there was not a significant difference (Log rank: 0.85; p:0.357; p>0.05). However, adenocarcinoma subtype was found to be related with unfavorable outcome with high local relapses and distant metastases (P<0.01). Conclusion: Despite the limited number of the cases in our retrospective study, it was found that in early stage lung cancer the type histology was far more prognostic than histological vascular invasion.