Clinical Significance Of Lymphatic Vessel Invasion In Stage Ⅰ Non-small Cell Lung Cancer Patients

Purpose:The aim of this retrospective study was to evaluate the prognostic influence of lymphatic vessel invasion (LVI) in stage Ⅰ non-small cell lung cancer (NSCLC) patients.Method:From January 2004 to December 2007, LVI was detected in 57 patients with T1N0M0 NSCLC; therefore,114 patients with the same pathology, T stage, and surgery method, but without LVI, were selected as the control group to compare survival. The clinical data, overall survival (OS), relapse-free survival (RFS), and metastasis location were recorded, and the follow-up data were accomplished by the author. The overall survival and relapse-free survival rates were estimated using the Kaplan-Meier method, log-rank test, and Cox proportional hazards analysisResult:There are 99 cases (99/171,57.89%) with adenocarcinoma,42 cases (42/171,24.56%) with Squamous cell carcinoma and 30 cases (30/171,17.54%) with other type of NSCLC. Tumor stage T1a and T1b were found in 96 and 75 cases, respectively. Totally 144 cases (144/171,84.21%) underwent lobetomy and the left 27 cases (27/171,15.79%) underwent limited resection. Only 41 cases (41/171,23.98%) underwent Postoperative treatment, including prevention chemotherapy and radiotherapy. The average follow-up length was 59.94±23.1 months. The 5-year overall survival rates of the LVI-negative and the LVI-positive groups were 90.54 and 70.1%, respectively (P=0.002).A multivariate analysis revealed LVI to be an independent predictive factor (hazard ratio=4.562; P=0.004). The 5-year overall survival rates for patients who received postoperative adjunctive therapy and those who did not in the LVI-positive group were 88.2 and 61.5%, respectively, with P value less than 0.05 in both univariate and multivariate analyses.Conclusion:LVI is a poor prognostic factor in stage I NSCLC patients; postoperative adjunctive therapy is needed to improve the prognosis of stage I NSCLC patients with LVI...