2024 World Conference on Lung Cancer (WCLC) - Posters-P1.06C.05 The Impact of Lymphovascular Invasion as Prognostic Factor on Long-Term Survival in More Than 3500 Resected NSCLC Patients

P1.06C.05 The Impact of Lymphovascular Invasion as Prognostic Factor on Long-Term Survival in More Than 3500 Resected NSCLC Patients

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This study evaluates the impact of lymphovascular invasion (LVI) as a prognostic factor on long-term survival in patients with resectable non-small cell lung cancer (NSCLC). The significance of both lymphatic invasion (LI) and venous invasion (VI) was investigated, as these factors are not included in the current 9th TNM classification for NSCLC. The study analyzed survival outcomes for over 3,500 NSCLC patients who underwent surgical resection, with specific focus on how LVI affects long-term survival.<br /><br />Exclusion criteria included stage IIIA cancer, prior neoadjuvant therapy, positive resection margins, survival under 90 days, and ECOG performance status greater than 1. The analysis was performed using data from January 2010 to December 2022 from a single institution's database, with cohorts matched according to the 8th TNM classification. Adjuvant radio- and chemotherapy were applied according to current guidelines.<br /><br />Results showed that patients without lymphovascular invasion (LIVI-) had significantly better survival outcomes compared to those with lymphatic (LI), venous (VI), or both invasions (LIVI). Mean survival in node-negative patients was notably higher for those without LVI, being 84.2 months for LIVI-, compared to 48.5 months for LI, 50.9 months for VI, and 36.3 months for LIVI groups. Similarly, three- and five-year survival rates were superior in the LIVI- group.<br /><br />Hazard ratios indicated increased mortality risk associated with LI and VI, with hazard ratios of 1.45, 1.27, and 1.51 for LI, VI, and LIVI, respectively, as compared to LIVI-. The study underscores the negative influence of LVI on the long-term survival of resectable NSCLC and suggests that lymphovascular invasion could be considered for inclusion in future TNM classification updates. However, since it was conducted at a single center, the findings might not be universally applicable.

Asset Subtitle

Fabian Doerr

Meta Tag

Speaker Fabian Doerr

Topic Pathology & Biomarkers

Keywords

lymphovascular invasion

prognostic factor

non-small cell lung cancer

NSCLC

survival outcomes

lymphatic invasion

venous invasion

TNM classification

hazard ratios

long-term survival