Lymphovascular space invasion and tumor differentiation are predictors for postoperative recurrence in patients with pathological stage I nonsmall cell lung cancer

Ying-Yi Chen; Tsai-Wang Huang; Wen-Chiuan Tsai; Li-Fan Lin; Jian-Bo Cheng; Shih-Chun Lee; Hung Chang

doi:10.1016/j.jcma.2014.05.008

Lymphovascular space invasion and tumor differentiation are predictors for postoperative recurrence in patients with pathological stage I nonsmall cell lung cancer

J Chin Med Assoc. 2014 Aug;77(8):416-21. doi: 10.1016/j.jcma.2014.05.008. Epub 2014 Jul 12.

Authors

Ying-Yi Chen¹, Tsai-Wang Huang¹, Wen-Chiuan Tsai², Li-Fan Lin³, Jian-Bo Cheng¹, Shih-Chun Lee¹, Hung Chang⁴

Affiliations

¹ Division of Thoracic Surgery, Department of Surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, ROC.
² Department of Pathology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, ROC.
³ Department of Nuclear Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, ROC.
⁴ Division of Thoracic Surgery, Department of Surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, ROC. Electronic address: hung@mail.ndmctsgh.edu.tw.

PMID: 25028298
DOI: 10.1016/j.jcma.2014.05.008

Abstract

Background: We investigated factors predicting postoperative recurrence in patients with pathological Stage I nonsmall cell lung cancer (NSCLC).

Methods: All patients with clinical Stage I NSCLC who underwent surgical resection at Tri-Service General Hospital in Taiwan between January 2002 and June 2006 were reviewed retrospectively. All study patients underwent standard staging workups. We reviewed the records of 261 patients with an average follow-up of 93 months; we then included 179 patients with pathological Stage I.

Results: Two hundred sixty-one patients with clinical Stage I NSCLC were eligible. There were no significant differences in sex, tumor histopathology, location, and age between the two groups (recurrence and nonrecurrence), except for tumor differentiation (p = 0.002), survival rate (p < 0.001), lymphovascular space invasion (LVSI; p = 0.007), advanced pathology stage (p = 0.022), maximum standard uptake value (SUVmax; p = 0.027), tumor size (p < 0.011), and carcinoembryonic antigen (CEA) levels (p = 0.013). Overall survival was significantly related to postoperative recurrence (p < 0.001) in patients with pathological Stage I, in whom recurrences developed in 11.17%. Only 179 patients with pathological Stage I NSCLC, including 20 patients with postoperative recurrences, were selected. Tumor differentiation (odds ratio 3.581, p = 0.058) and LVSI (odds ratio 5.374, p = 0.020) were independent factors predicting recurrence.

Conclusion: Tumor differentiation and LVSI were predictors of postoperative relapse for patients with pathological stage I NSCLC. Risk factors of postoperative recurrence in patients with pathological Stage I NSCLC may enable us to optimize the patient selection for postoperative adjuvant therapies to prevent possibly occult micrometastases.

Keywords: nonsmall cell lung cancer; postoperative recurrence; prognostic factors; survival rate.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Carcinoma, Non-Small-Cell Lung / mortality
Carcinoma, Non-Small-Cell Lung / pathology*
Carcinoma, Non-Small-Cell Lung / surgery
Female
Follow-Up Studies
Forecasting
Humans
Lung Neoplasms / mortality
Lung Neoplasms / pathology*
Lung Neoplasms / surgery
Lymphatic Vessels / pathology*
Male
Middle Aged
Neoplasm Invasiveness
Neoplasm Recurrence, Local
Neoplasm Staging
Postoperative Period
Prognosis
Retrospective Studies
Risk Factors