Lymphatic vessel invasion in pathologic stage I and II non-small cell lung tumors

Tumor node-metastasis staging is essential for predicting the prognosis of patients with non-small cell lung cancer (NSCLC); however, its accuracy remains limited. The aim of this study was to establish the significant predictors of outcome for patients with pathologic stage I or II NSCLC.

We reviewed the records of patients with pathologic stage I and II NSCLC retrospectively. After the exclusion of those who underwent sublobar resection, received neoadjuvant treatment, or died within 30 days of surgery, 271 patients treated between January, 2004 and December, 2010 were analyzed. We investigated whether lymphatic vessel invasion (LVI) grade was associated with prognosis in stage I or II NSCLC.

The median age of the patients was 64 years. Of the 198 and 73 patients with pathologic stage I and stage II disease, respectively, 73 (26.9%) had LVI. Thirteen patients had a high degree of LVI. Although LVI was not associated with overall survival (p = 0.13), a high degree of LVI was associated with poor survival (p < 0.001). Multivariate analysis revealed that diabetes mellitus (p = 0.001), tumor size (p < 0.001), LVI grade (p < 0.001), and pathologic stage II (p = 0.040) were all associated with overall survival.

A higher grade of LVI was predictive of a worse prognosis. Further study is required to establish the prognostic role of moderate and marked LVI in NSCLC.