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Lymphatic permeation and vascular invasion should not be integrated as lymphovascular invasion in lung adenocarcinoma

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Abstract

Objective

Lymphatic permeation (LY) and vascular invasion (VI) are well-known as postoperative prognostic factors in non-small cell lung cancer (NSCLC). Some reports use the term “lymphovascular invasion (LVI)” in reference to the integration of LY and VI. The purpose in this study is to elucidate whether NSCLC with LY or VI can be labeled as LVI-positive NSCLC or it should be treated as an LY- or VI-positive tumor, respectively.

Methods

We reviewed 601 completely resected lung adenocarcinomas and squamous cell carcinomas, and examined the respective prognostic and biological significance of LY and VI.

Results

Among 454 adenocarcinomas, multivariate survival analyses showed that LY and VI were unfavorable prognostic factors in stages II and III and stages I and II, respectively. Conversely, this relationship was not found among 147 squamous cell carcinomas. Patients with adenocarcinomas with LY and VI had a significantly worse prognosis than those with adenocarcinomas with LY or VI in stage II, but not in stage I. Among 149 recurrent adenocarcinomas, only VI had a strong effect on early recurrence and shorter post-recurrence survival. LY and VI were predictors for multiple organ recurrence of adenocarcinoma. The recurrence of adenocarcinoma with LY was high in the ipsilateral mediastinal lymph nodes, whereas VI was significantly correlated with distant metastasis to organs, such as the brain, liver, and adrenal gland.

Conclusions

LY and VI have differing effects postoperative prognosis and recurrence-relevant events, suggesting that these pathological findings should not be integrated as LVI.

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References

  1. Oudkerk M, Devaraj A, Vliegenthart R, Henzler T, Prosch H, Heussel C, et al. European position statement on lung cancer screening. Lancet Oncol. 2017;18:e754–66.

    Article  Google Scholar 

  2. Yang D, Liu Y, Bai C, Wang X, Powell CA. Epidemiology of lung cancer and lung cancer screening programs in China and the United States. Cancer Lett. 2020;468:82–7.

    Article  CAS  Google Scholar 

  3. Sawabata N, Miyaoka E, Asamura H, Nakanishi Y, Eguchi K, Mori M, et al. Japanese Joint Committee for Lung Cancer Registration. Japanese lung cancer registry study of 11,663 surgical cases in 2004: demographic and prognosis changes over decade. J Thorac Oncol. 2011;6:1229–35.

    Article  Google Scholar 

  4. Kosaka T, Shimizu K, Nakazawa S, Iijima M, Ohtaki Y, Azuma Y, et al. Clinicopathological features of small-sized peripheral squamous cell lung cancer. Mol Clin Oncol. 2020;12:69–74.

    PubMed  Google Scholar 

  5. Kinoshita T, Ohtsuka T, Yotsukura M, Asakura K, Goto T, Kamiyama I, et al. Prognostic impact of preoperative tumor marker levels and lymphovascular invasion in pathological stage I adenocarcinoma and squamous cell carcinoma of the lung. J Thorac Oncol. 2015;10:619–28.

    Article  CAS  Google Scholar 

  6. Hamanaka R, Hamanaka R, Ito H, Nakayama H, Yamada K, Masuda R, et al. Prognostic impact of vascular invasion and standardization of its evaluation in stage I non-small cell lung cancer. Diagn Pathol. 2015;10:17.

    Article  Google Scholar 

  7. Al-Alao BS, Gately K, Nicholson S, McGovern E, Young VK, O’Byrne KJ. Prognostic impact of vascular and lymphovascular invasion in early lung cancer. Asian Cardiovasc Thorac Ann. 2014;22:55–64.

    Article  Google Scholar 

  8. Okiror L, Harling L, Toufektzian L, King J, Routledge T, Harrison-Phipps H, et al. Prognostic factors including lymphovascular invasion on survival for resected non-small cell lung cancer. J Thorac Cardiovasc Surg. 2018;156:785–93.

    Article  Google Scholar 

  9. Wang S, Xu J, Wang R, Qian F, Yang W, Qiao R, et al. Adjuvant chemotherapy may improve prognosis after resection of stage I lung cancer with lymphovascular invasion. J Thorac Cardiovasc Surg. 2018;156:2006-2015 e2.

    Article  Google Scholar 

  10. Lababede O, Meziane M, Rice T. Seventh edition of the cancer staging manual and stage grouping of lung cancer: quick reference chart and diagrams. Chest. 2011;139:183–9.

    Article  Google Scholar 

  11. Shindoh J, Andreou A, Aloia TA, Zimmitti G, Lauwers G, Laurent A, et al. Microvascular invasion does not predict long-term survival in hepatocellular carcinoma up to 2 cm: reappraisal of the staging system for solitary tumors. Ann Surg Oncol. 2013;20:1223–9.

    Article  Google Scholar 

  12. Ueno M, Morizane C, Ikeda M, Okusaka T, Ishii H, Furuse J. A review of changes to and clinical implications of the eighth TNM classification of hepatobiliary and pancreatic cancers. Jpn J Clin Oncol. 2019;49:1073–82.

    Article  Google Scholar 

  13. Ettinger DS, Wood DE, Aggarwal C, Aisner D, Akerley W, Bauman J, et al. NCCN guidelines insights: non-small cell lung cancer, version 1.2020. J Natl Compr Canc Netw. 2019;17:1464–72.

    Article  Google Scholar 

  14. Rami-Porta R, Bolejack V, Crowley J, Ball D, Kim J, Lyons G, et al. IASLC staging and prognostic factors committee, advisory boards and participating institutions. The IASLC lung cancer staging project: proposals for the revisions of the T descriptors in the forthcoming eighth edition of the TNM classification for lung cancer. J Thorac Oncol. 2015;10:990–1003.

    Article  Google Scholar 

  15. Travis WD, Brambilla E, Nicholson AG, Yatabe Y, Austin J, Beasley MB, et al. WHO Panel. The 2015 World Health Organization classification of lung tumors: impact of genetic, clinical and radiologic advances since the 2004 classification. J Thorac Oncol. 2015;10:1243–60.

    Article  Google Scholar 

  16. Goldstraw P, Chansky K, Crowley J, Rami-Porta R, Asamura H, Eberhardt W, et al. International Association for the Study of Lung Cancer Staging and Prognostic Factors Committee, Advisory Boards, and Participating Institutions; International Association for the Study of Lung Cancer Staging and Prognostic Factors Committee Advisory Boards and Participating Institutions. The IASLC Lung Cancer Staging Project: proposals for Revision of the TNM Stage Groupings in the Forthcoming (Eighth) Edition of the TNM Classification for Lung Cancer. J Thorac Oncol. 2016;11:39–51.

    Article  Google Scholar 

  17. Nakajima T, Morimoto J, Yoshino I. Tumor spread through air space, the clinical implications for T factor and effects on the disease recurrence and prognosis. J Thorac Dis. 2018;10:539–43.

    Article  Google Scholar 

  18. Noma D, Inamura K, Matsuura Y, Hirata Y, Nakajima T, Yamazaki H, et al. Prognostic effect of lymphovascular invasion on TNM staging in stage I non-small-cell lung cancer. Clin Lung Cancer. 2018;19:e109–22.

    Article  Google Scholar 

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Funding

JSPS KAKENHI Grant Number 17K16617.

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Authors and Affiliations

  1. Department of Thoracic Surgery, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, 3-18-22, Honkomagome, Bunkyo-ku, Tokyo, 113-8677, Japan

    Yusuke Sugita, Tomonari Kinoshita, Toshiyuki Shima, Naomichi Sasaki, Mao Uematsu, Reiko Shimizu, Masahiko Harada & Hirotoshi Horio

  2. Department of Thoracic Surgery, Tokyo Medical and Dental University, Medical Hospital, Tokyo, 113-8519, Japan

    Yusuke Sugita

  3. Division of Thoracic Surgery, Keio University School of Medicine, Tokyo, 160-8682, Japan

    Tomonari Kinoshita & Toshiyuki Shima

  4. Department of Pathology, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, Tokyo, 113-8677, Japan

    Tsunekazu Hishima

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  1. Yusuke Sugita
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  2. Tomonari Kinoshita
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  3. Toshiyuki Shima
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  4. Naomichi Sasaki
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  7. Masahiko Harada
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  8. Tsunekazu Hishima
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  9. Hirotoshi Horio
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Correspondence to Tomonari Kinoshita.

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Sugita, Y., Kinoshita, T., Shima, T. et al. Lymphatic permeation and vascular invasion should not be integrated as lymphovascular invasion in lung adenocarcinoma. Gen Thorac Cardiovasc Surg 69, 1070–1078 (2021). https://doi.org/10.1007/s11748-020-01576-z

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  • DOI: https://doi.org/10.1007/s11748-020-01576-z

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