Visceral pleural invasion is not predictive of survival in patients with lung cancer and smaller tumor size.
Visceral pleural invasion is not predictive of survival in patients with lung cancer and smaller tumor size.
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DOI：
10.1016/j.athoracsur.2013.03.085
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发表时间：
2013-06
影响因子：
4.6
通讯作者：
Mehran, Reza J.
中科院分区：
文献类型：
--
作者：
David, Elizabeth;Thall, Peter F.;Kalhor, Neda;Hofstetter, Wayne L.;Rice, David C.;Roth, Jack A.;Swisher, Stephen G.;Walsh, Garrett L.;Vaporciyan, Ara A.;Wei, Caimea;Mehran, Reza J.
内脏胸膜浸润（VPI）被用作非小细胞肺癌（NSCLC）不良预后的指标。本回顾性研究的目的是评估VPI对淋巴结阴性NSCLC患者无病生存期（DFS）和总生存期（OS）的影响。1998年至2009年间，1166例病理性N0M0 NSCLC患者接受了肺叶切除术。214例VPI患者与952例无VPI患者相比。中位随访时间为59个月。在多因素分析中，VPI、较大的肿瘤大小、年龄、女性和较差的工作状态与OS降低显著相关。相比之下，较大的肿瘤大小，女性性别和较差的表现，但明显不是VPI，与DFS下降有关。在检查了VPI和T亚组的相互作用后，我们发现VPI对肿瘤大小较小的T1a、T1b或T2a患者亚组的OS或DFS没有显著影响。相比之下，VPI对肿瘤bb0 5cm、T2b和T3的DFS有不利影响，VPI-T3相互作用对DFS的影响有统计学意义，但对OS无统计学意义。VPI对NSCLC生存的影响因肿瘤大小而异，在小于5cm的肿瘤中，VPI与OS或DFS的相关性不强，但在T2b和T3肿瘤中，VPI对DFS的负面影响较大。使用VPI将T1肿瘤抢到更高的T类别是不合理的，因为它会歪曲这些VPI-T亚组效应。
Visceral pleural invasion (VPI) is used as an indicator of adverse prognosis in non-small cell lung carcinoma (NSCLC). The purpose of this retrospective study was to evaluate the impact of VPI on disease-free survival (DFS) and overall survival (OS) in patients with node-negative NSCLC. Between 1998 and 2009, 1166 patients with pathological N0M0 NSCLC underwent surgical resection by lobectomy. 214 patients with VPI were compared to 952 without. Median follow-up was 59 months. In multivariate analysis, VPI, larger tumor size, older age, female gender, and poor performance status were significantly associated with decreased OS. In contrast, larger tumor size, female gender, and poor performance, but notably not VPI, were associated with decreased DFS. After examining interactive effects of VPI and T subgroups, we found that VPI did not significantly affect either OS or DFS in the subgroups of patients with smaller tumor sizes T1a, T1b, or T2a. In contrast, a deleterious effect of VPI on DFS was seen for tumors > 5cm, T2b and T3, with the VPI-T3 interaction effect on DFS being statistically significant but not for OS. The effect of VPI on survival in NSCLC varies greatly with tumor size, with VPI not strongly associated with OS or DFS in tumors less than 5cm, but showing large negative effects on DFS for T2b and T3 tumors. Using VPI to upstage T1 tumors to a higher T category is not warranted, since it would misrepresent these VPI-T subgroup effects.
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影响因子：
--
作者：
Fisher, RA
通讯作者：
Fisher, RA
影响因子：
20.4
作者：
Groome, Patti A.;Bolejack, Vanessa;Goldstraw, Peter
通讯作者：
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影响因子：
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作者：
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影响因子：
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通讯作者：
Miyaoka, Etsuo
DOI：
10.1016/j.jtcvs.2004.11.021
发表时间：
2005-07-01
影响因子：
6
作者：
Shimizu, K;Yoshida, J;Nishiwaki, Y
通讯作者：
Nishiwaki, Y