2023 World Conference on Lung Cancer (Posters)-EP07.04. Lymphatic Vascular Invasion: Diagnostic Variability and Overall Survival Impact on Patients Undergoing Surgical Resection of NSCLC

EP07.04. Lymphatic Vascular Invasion: Diagnostic Variability and Overall Survival Impact on Patients Undergoing Surgical Resection of NSCLC - PDF(Abstract)

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This research investigates the impact of lymphatic vascular invasion (LVI) on the overall survival (OS) of patients with surgically resectable non-small cell lung cancer (NSCLC). The study aims to assess the factors associated with LVI-positive tumors and the effect of LVI on OS for NSCLC patients who undergo lobectomy or are not typically candidates for adjuvant systemic therapy.<br /><br />The researchers used data from the National Cancer Database (NCDB) from 2010-2015. They analyzed patients who underwent lobectomy or sub-lobar resection and had at least ten lymph nodes examined. Propensity score matching (PSM) was utilized to adjust for OS factors and determine the impact of LVI on OS based on the grade and node stage. The study also investigated the impact of LVI on OS for lobectomy patients with different tumor sizes and for sub-lobar resection patients.<br /><br />The results showed that LVI was reported in 21.3% of the 32,793 eligible patients, with higher rates in academic medical centers and institutions with populations over 1,000,000. LVI was independently associated with a significant decrease in OS. PSM analysis revealed that LVI had a consistent negative impact on OS for each node stage and tumor grade. LVI also had a negative impact on OS for lobectomy patients with different tumor sizes. Among patients undergoing sub-lobar resection, only 9.1% had adequate node dissection, but for those without it, LVI was associated with decreased OS.<br /><br />In conclusion, LVI varied depending on the hospital location/type and population but consistently had a negative impact on OS independent of node stage and tumor grade. The study highlights the need for standardization of LVI as a staging variable and suggests considering LVI as a sole determinant for systemic therapy for patients with pT1N0M0 tumors undergoing lobectomy and for sub-lobar resection patients who did not achieve adequate node dissection.

Asset Subtitle

Kemnasom Nwanwene

Meta Tag

Speaker Kemnasom Nwanwene

Topic Early-Stage NSCLC: Progress in Pathology

Keywords

lymphatic vascular invasion

overall survival

non-small cell lung cancer

surgically resectable

lobectomy

adjuvant systemic therapy

National Cancer Database

propensity score matching

node stage

tumor grade