Skip to main content

Advertisement

Log in

Classification of parietal pleural invasion at adhesion sites with surgical specimens of lung cancer and implications for prognosis

  • Original Article
  • Published:
Virchows Archiv Aims and scope Submit manuscript

Abstract

Parietal pleural invasion of non-small cell lung cancer (NSCLC) is a factor for poor prognosis, and a tumor of any size that invades the parietal pleura is classified as T3. However, with microscopic invasion beyond elastic fibers of the visceral pleura but no penetration to the parietal pleura at tight adhesion sites (we term this p1–3), classification as to the T factor is unclear. Among 1,179 consecutive patients with NSCLCs who underwent curative surgery between 1980 and 2002, 20 were in this category. Here, a comparison was made with subgroups of p stages IB, II, and IIIA with regard to histology, pleural invasion, and survival rates. To maximize the power of assessing prognostic potential, we set the significance level at 0.10, one-sided. The p1–3 condition sites of the 20 cases were the parietal pleura for 17 cases and the pericardium, diaphragm, and chest wall for one each of the remainder. The 5-year survival rate for these p1–3 patients was 71.6%. Significant differences were observed between p1–3 and IIIA groups. Although the 5-year survival rates did not significantly differ between p1–3 and T3N0 or unequivocal T3 subgroups, the prognosis of p1–3 patients was rather better than that of T3 and identical to T2. It was demonstrated that p1–3 status is not a factor warranting T3 classification for NSCLCs. Considering the prognosis, pathologic p1–3 tumors should be managed as a T2 disease for the present.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5
Fig. 6
Fig. 7

Similar content being viewed by others

References

  1. Brewer LA, Bai AF, Little JN, Pardo GR (1958) Carcinoma of the lung: practical classification of early diagnosis and survival treatment. JAMA 166:1149–1154

    CAS  Google Scholar 

  2. Ichinose Y, Yano T, Asoh H, Yokoyama H, Yoshino I, Katsuda Y (1995) Prognostic factors obtained by a pathologic examination in completely resected non-small-cell lung cancer. An analysis in each pathologic stage. J Thorac Cardiovasc Surg 110:601–605

    Article  PubMed  CAS  Google Scholar 

  3. Manac'h D, Riquet M, Medioni J, Le Pimpec-Barthes F, Dujon A, Danel C (2001) Visceral pleura invasion by non-small cell lung cancer: an underrated bad prognostic factor. Ann Thorac Surg 71:1088–1093

    Article  PubMed  Google Scholar 

  4. Mountain CF (1997) Revisions in the international system for staging lung cancer. Chest 111:1710–1717

    Article  PubMed  CAS  Google Scholar 

  5. International Union Against Cancer (2002) TNM classification of malignant tumours, 6th edn. Wiley-Liss, New York, pp 97–103

    Google Scholar 

  6. Japan Lung Cancer Society (2003) General rule for clinical and pathologic record of lung cancer [in Japanese], 6th edn. Kanehara, Tokyo

    Google Scholar 

  7. Makuch R, Simon R (1978) Sample size requirements for evaluating a conservative therapy. Cancer Treat Rep 62:1037–1040

    PubMed  CAS  Google Scholar 

  8. Bunker ML, Raab SS, Landreneau RJ, Silverman JF (1999) The diagnosis and significance of visceral pleural invasion in lung carcinoma. Histologic predictors and the role of elastic stains. Am J Clin Pathol 112:777–783

    PubMed  CAS  Google Scholar 

  9. Gallagher B, Urbanski SJ (1990) The significance of pleural elastica invasion by lung carcinomas. Hum Pathol 21:512–517

    Article  PubMed  CAS  Google Scholar 

  10. Miura H, Taira O, Uchida O, Kato H (1998) Invasion beyond interlobar pleura in non-small cell lung cancer. Chest 114:1301–1304

    Article  PubMed  CAS  Google Scholar 

  11. Magdeleinat P, Alifano M, Benbrahem C, Spaggiari L, Porrello C, Puyo P, Levasseur P, Regnard JF (2001) Surgical treatment of lung cancer invading the chest wall: results and prognostic factors. Ann Thorac Surg 71:1094–1099

    Article  PubMed  CAS  Google Scholar 

  12. Miller JD, Gorenstein LA, Patterson GA (1992) Staging: the key to rational management of lung cancer. Ann Thorac Surg 53:170–178

    Article  PubMed  CAS  Google Scholar 

  13. Facciolo F, Cardillo G, Lopergolo M, Pallone G, Sera F, Martelli M (2001) Chest wall invasion in non-small cell lung carcinoma: a rationale for en bloc resection. J Thorac Cardiovasc Surg 121:649–656

    Article  PubMed  CAS  Google Scholar 

  14. Nakano N, Yasumitsu T, Kotake Y, Morino H, Ikezoe J (1994) Preoperative histologic diagnosis of chest wall invasion by lung cancer using ultrasonically guided biopsy. J Thorac Cardiovasc Surg 107:891–895

    PubMed  CAS  Google Scholar 

  15. Albain KS, Hoffman PC, Little AG, Bitran JD, Golomb HM, DeMeester TR, Griem ML, Blough RR, Skosey C (1986) Pleural involvement in stage IIIM0 non-small-cell bronchogenic carcinoma. A need to differentiate subtypes. Am J Clin Oncol 9:255–261

    Article  PubMed  CAS  Google Scholar 

  16. Kang JH, Kim KD, Chung KY (2003) Prognostic value of visceral pleura invasion in non-small cell lung cancer. Eur J Cardiothorac Surg 23:865–869

    Article  PubMed  Google Scholar 

  17. McCaughan BC, Martini N, Bains MS, McCormack PM (1985) Chest wall invasion in carcinoma of the lung. Therapeutic and prognostic implications. J Thorac Cardiovasc Surg 89:836–841

    PubMed  CAS  Google Scholar 

  18. Ratto GB, Piacenza G, Frola C, Musante F, Serrano I, Giua R, Salio M, Jacovoni P, Rovida S (1991) Chest wall involvement by lung cancer: computed tomographic detection and results of operation. Ann Thorac Surg 51:182–188

    Article  PubMed  CAS  Google Scholar 

  19. Akay H, Cangir AK, Kutlay H, Kavukcu S, Okten I, Yavuzer S (2002) Surgical treatment of peripheral lung cancer adherent to the parietal pleura. Eur J Cardiothorac Surg 22:615–620

    Article  PubMed  Google Scholar 

  20. Albertucci M, DeMeester TR, Rothberg M, Hagen JA, Santoscoy R, Smyrk TC (1992) Surgery and the management of peripheral lung tumors adherent to the parietal pleura. J Thorac Cardiovasc Surg 103:8–12

    PubMed  CAS  Google Scholar 

Download references

Acknowledgements

This study was supported by Grants-in-aid from the Ministry of Education, Sports, Culture, Science and Technology, as well as grants from the Ministry of Health, Labour and Welfare, the Smoking Research Foundation, and the Vehicle Racing Commemorative Foundation. We thank Ms. Miyuki Kogure, Kazuko Yokokawa, and Mr. Motoyoshi Iwakoshi for their technical assistance. We also thank Mr. Hiroyuki Kubonoya for his artistic assistance.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Yukitoshi Satoh.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Satoh, Y., Ishikawa, Y., Inamura, K. et al. Classification of parietal pleural invasion at adhesion sites with surgical specimens of lung cancer and implications for prognosis. Virchows Arch 447, 984–989 (2005). https://doi.org/10.1007/s00428-005-0031-2

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00428-005-0031-2

Keywords

Navigation