Prognostic value of the limited visceral plural invasion solid part of the lung cancer

Prognostic value of the limited visceral plural invasion solid part of the lung cancer -

By Laura Cowen, medwireNews Reporter

Visceral invasion plural (VPI) is an important predictor of survival in patients with small tumors of the lung solid, but not in patients with solid tumors part, the results of Japanese studies indicate.

Kenji Suzuki and colleagues from Juntendo University School of Medicine in Tokyo, explained that although VPI "has long been recognized as an adverse prognostic factor" in lung cancer non-small cell ( NSCLC), its impact in tumors with ground-glass opacity (GGO) lesions, including those with a solid partial aspect, is controversial because of their nature minimally invasive.

to better understand the importance of IPV in these tumor types, Suzuki and team retrospectively reviewed CT thin section (TDM) from 446 patients (mean age 66 years, 50.4% male) with surgically resected, node-solid part NSCLC or pure-solid less than 30 mm.

a solid part nodule (n = 237) was defined as a tumor with focal nodular opacity which contained both solid and components EOG (consolidation ratio / tumor from 0 to <1 , 0), while a pure-solid nodule (n = 209) showed no consolidation EOG.

The researchers report in The Annals of Thoracic Surgery that VPI was present in 24 (10%) solid and 79 part nodules (38%) pure-solid nodules .

multivariate analysis, IPV, with the invasion of vessels, maximum tumor diameter and level of carcinoembryonic antigen, significantly and independently predicted overall survival in patients with nodules pur- solids. Indeed, the 5 year survival rate in patients with pure-solid nodules with VPI (70.1%) was significantly worse than patients without VPI (81.3%).

However, IPV was not a significant predictor of overall survival in patients with partially solid nodules, but consolidation / report of the tumor and the levels of carcinoembryonic antigen were.

in this group, 5-year survival rates in patients with and without IPV were 85.6% and 94.9% respectively.

These results suggest that "VPI plays a completely different role in each subtype of early stage NSCLC based on the findings of thin-section CT scan," Suzuki et al note.

They say it is important because the presence of VPI "increases the T factor in the staging of T1 to T2 and upstages a stage IA tumor stage IB pathologically," which in turn can influence the decision of a clinician to administer adjuvant chemotherapy.

"Thus, the upgrade of the TNM classification and administration of postoperative chemotherapy based pleural factors should not be considered for lung cancer patients with predominantly EOG, "the team concludes.

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