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Blood vessel invasion is a major prognostic factor in resected non-small cell lung cancer
R Kessler1, B Gasser, G Massard
1Service de Chirurgie Thoracique, Hôpitaux Universitaires, Strasbourg, France.
Background:
We examined the prognostic value of histologic indices in non-small cell lung cancer with particular interest in major blood vessel invasion.
Methods:
We studied 593 patients who had curative resection between November 1983 and December 1988. We determined the histology, T and N status, peritumoral lung tissue invasion, tumor stroma, necrosis, mitotic rate, and blood vessel invasion.
Results:
The median patient survival of the whole series was 3.2 years, with a 5-year survival of 38.9%. In univariate analysis, a high T stage, a high percentage of necrosis, blood vessel invasion, and N stage significantly worsened the survival. In multivariate analysis, only blood vessel invasion and, less significantly, T stage and lymph node metastasis remained independent prognostic factors.
Conclusions:
These results highlight the negative prognostic value of blood vessel invasion in non-small cell lung cancer and suggest that blood vessel invasion, T stage, and node metastasis are three unrelated and distinctive characteristics of resected non-small cell lung cancer.