Prognostic factors including lymphovascular invasion on survival for resected non-small cell lung cancer

被引:36
作者
Okiror, Lawrence
Harling, Leanne
Toufektzian, Levon
King, Juliet
Routledge, Tom
Harrison-Phipps, Karen
Pilling, John
Veres, Lukacs
Lal, Ruchi
Bille, Andrea [1 ]
机构
[1] Guys Hosp, Dept Thorac Surg, 6th Fl,Borough Wing, London SE1 9RT, England
关键词
lymphovascular invasion; non-small cell lung cancer; overall survival; VINORELBINE PLUS CISPLATIN; GYNECOLOGIC-ONCOLOGY-GROUP; VISCERAL PLEURAL INVASION; PELVIC RADIATION-THERAPY; MONOCLONAL-ANTIBODY; LYMPHATIC INVASION; VASCULAR INVASION; CIGARETTE-SMOKING; VESSEL INVASION; STAGE;
D O I
10.1016/j.jtcvs.2018.02.108
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Objectives: The aim of this study was to report on the influence of tumor lympho-vascular invasion on overall survival and in patients with resected non-small cell lung cancer and identify prognostic factors for survival. Methods: This is a retrospective observational study of a consecutive series of patients who had surgical resection of non-small cell lung cancer in a single institution. The study covers a 3-year period. Overall survival was estimated by Kaplan-Meier method and multivariate Cox regression analysis was used to evaluate the relationship of lymphovascular invasion and other clinicopathologic variables. A multivariate regression was used to assess the relationship between tumor lymphovascular invasion and other clinical and pathologic characteristics. Results: A total of 524 patients were identified and included in the study. Two hundred twenty-five patients (43%) had tumors with lymphovascular invasion. Patients with tumor lymphovascular invasion had a lower overall survival (P < .0001). Tumor lymphovascular invasion was independently associated with visceral pleural involvement (P < .0001). In a multivariable model, lymphovascular invasion (hazard ratio [HR], 2.58; 95% confidence interval [CI], 1.63-4.09; P < .0001), parietal pleural invasion (HR, 45.4; 95% CI, 2.08-990; P = .015), advanced age (HR, 1.028; 95% CI, 1.009-1.048; P = .004), and N2 lymph node involvement (HR, 1.837; 95% CI, 1.257-2.690; P = .002) were independent prognostic factors for lower overall survival. Conclusions: Lymphovascular invasion is associated with a worse overall survival in patients with resected non-small cell lung cancer regardless of tumor stage. Parietal pleural involvement, N2 nodal disease, and advanced age independently predict poor overall survival.
引用
收藏
页码:785 / 793
页数:9
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