Vascular Invasion Predicts Recurrence in Stage IA2-IB Lung Adenocarcinoma but not Squamous Cell Carcinoma
Abstract
Background Lymphovascular invasion (LVI) is an adverse prognostic feature in resected stage I non-small cell lung cancer (NSCLC); however, it is unclear if the prognostic significance applies to both lung adenocarcinoma (LUAD) and squamous cell carcinoma (LUSC).Materials and methods A retrospective review of H&E-stained slides from surgically resected AJCC 8 th ed. stage IA2-IB LUAD (n = 344) and LUSC (n = 102) from two institutions was performed. LVI was defined as either lymphatic (LI) or vascular (VI) invasion. Outcomes were assessed by 5-year recurrence-free survival (RFS) estimates using the Kaplan-Meier method.Results The cohorts of LUAD and LUSC showed no significant differences in 5-year RFS (81% each), stage, age, race, or surgical procedure. The presence of LVI, VI, and LI was predictive of 5-year RFS for LUAD (LVI + 71% vs. LVI - 92%, P < 0.001; VI + 64% vs. VI - 90%, P < 0.001; LI + 75% vs. LI - 84%, P = 0.030) but not LUSC (LVI + 84% vs. LVI - 79%, P = 0.740; VI + 83% vs. VI- 80%, P = 0.852; LI + 84% vs. LI - 81%, P = 0.757). Among LUAD with LVI, VI was a stronger predictor of 5-year RFS than the remaining subset of VI-LI + tumors (64% vs. 87%, P = 004). Subset analysis of LI among LUAD stratified by VI showed no significant prognostic advantage to adding LI for risk stratification (VI-LI + 87% vs. VI-LI - 92%, P = 0.347 & VI+LI + 62% vs. VI + LI- 66%, P = 0.422). VI was present in 36% of LUAD.Conclusion Vascular invasion is a strong predictor of recurrence in stage IA2-IB LUAD but not in LUSC. Adjuvant therapy trials should be directed at this subgroup.
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In the LUAD high-risk case, the FSM model highlighted the aggressive solid tumor histologic pattern and the focus of vascular invasion [35], [36] associated with an unfavorable prognosis.
“In the LUAD high-risk case, the FSM model highlighted the aggressive solid tumor histologic pattern and the focus of vascular invasion [35], [36] associated with an unfavorable prognosis.”
From Graph attention-based fusion of pathology images and gene expression for prediction of cancer survival (2024) · cites this paper as [36]
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- Authors
- Suaiti, L., Sullivan, T. B., Rieger-Christ, K. M., Servais, E. L., Suzuki, K., & Burks, E. J.
- Affiliations
- Boston University (US)
- Lahey Hospital and Medical Center (US)
- Corresponding author
- Burks, Eric J.
- Venue
- Clinical Lung Cancer
- Publisher
- Elsevier BV
- Published
- 2023-05
- Volume
- 24
- Issue
- 3
- Pages
- e126-e133
- ISSN
- 1525-7304 (ISSN-L)
- OpenAlex
- W4313201705
- Cited by
- 11
- References
- 38
- Citations by year
- 2026: 2 · 2025: 3 · 2024: 4 · 2023: 2
- FWCI
- 1.45
- Type
- journal article
- Language
- en
- Open access
- closed
- Licence
- Locations
- Clinical Lung Cancer (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Lung Cancer Diagnosis and Treatment
- Health Sciences › Medicine › Oncology › Lung Cancer Research Studies
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Metastasis and carcinoma case studies
- Keywords
- vascular invasion, lymphovascular invasion, lung adenocarcinoma, squamous cell carcinoma, non-small cell lung cancer, stage I lung cancer, recurrence-free survival, prognostic factors, lymphatic invasion, adjuvant therapy, risk stratification, surgical resection, molecular subtypes, EGFR, KRAS, anaplastic lymphoma kinase, BRAF, IDH1, IDH2
- MeSH terms
- Adenocarcinoma of Lung, Carcinoma, Non-Small-Cell Lung, Carcinoma, Squamous Cell, Humans, Lung Neoplasms, Neoplasm Invasiveness, Neoplasm Recurrence, Local, Prognosis, Retrospective Studies
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