Original article: general thoracicVisceral pleura invasion by non-small cell lung cancer: an underrated bad prognostic factor
Section snippets
Patients and methods
From April 1984 to December 1996, 1,585 patients underwent pulmonary surgical resection for bronchogenic carcinoma at Laennec Hospital and Boisguillaume Surgical Center. The surgical procedure was a potentially curative complete resection with extensive mediastinal lymph node dissection similar to that described by Martini and Flehinger [4]. All included patients had NSCLC (patients who had neoadjuvant chemotherapy or radiation therapy, as well as patients with prior history of malignancy were
Results
The VPI (group II) was identified in 19.1% of the resected specimens: group I (n = 1,036), group II (n = 245). Survival rates were 51.8% at 5 years and 33.8% at 10 years (median, 66 months) in group I, and 34.6% at 5 years and 27.9% at 10 years (median, 30 months) in group II. The difference between groups was highly significant (p = 0.00002).
The VPI was present in 10.4% of tumors 3 cm or less, in 19.6% of tumors between 3 and 5 cm and was significantly more frequent (p = 0.0001) in tumors
Comment
In our study, VPI was observed in 19.1% of resected lung specimens. It correlated with a tumor size larger than 3 cm and a more extensive mediastinal lymph node involvement. Survival rates decreased with such tumor characteristics, and lung cancer-related deaths were more frequent. This confirms what had been reported by Harpole and colleagues [10] in a multivariate study. The VPI is encountered in 11.5% [11] to 23.6% [12] of NSCLC.
We also observed that frequency of VPI is variable according to
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