WCLC 2025 - Posters & ePosters-P2.08 .03 Differentgrades of Visceral Pleura Invasion in Lung Adenocarcinomas Correlate With Aggressiveness and Poor Prognosis

P2.08 .03 Differentgrades of Visceral Pleura Invasion in Lung Adenocarcinomas Correlate With Aggressiveness and Poor Prognosis

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This retrospective single-center study investigated the prognostic significance of different grades of visceral pleural invasion (VPI) in lung adenocarcinoma (LUAD), specifically comparing PL1 and PL2 invasion. VPI is a recognized negative prognostic factor, with PL1 indicating tumor growth beyond the elastic layer but not reaching the pleural surface, and PL2 representing tumor extension onto the pleural surface.<br /><br />Ninety-seven patients with PL1 or PL2 LUAD who underwent radical surgery between 2017 and 2020 were analyzed, with at least three years of follow-up. Clinical outcomes assessed included overall survival (OS), cancer-specific survival (CSS), and disease-free survival (DFS). Uni- and multivariable analyses evaluated associations of VPI extent with histologic and clinical risk factors.<br /><br />Results showed that PL2 tumors (43.3% of cases) were significantly associated with poorer OS, CSS, and DFS compared to PL1 tumors. PL2 status correlated strongly with more aggressive features including high-grade (G3) differentiation (p=0.005), prevalence of high-grade histologic patterns (p=0.02), lymphovascular invasion (p=0.001), lymph node disease (p=0.04), and higher incidence of distant metastases (p=0.002). Multivariable analysis identified PL2 invasion, high-grade patterns, and G3 differentiation as independent predictors of poor prognosis.<br /><br />The study concludes that PL2 VPI defines a more aggressive LUAD subtype with greater metastatic potential, highlighting the prognostic importance of precise VPI staging. This suggests that patients with PL2 tumors may benefit from tailored follow-up and adjuvant therapies even in early-stage disease. The authors recommend development of a comprehensive prognostic scoring system incorporating clinical, pathological, molecular, and genetic factors through large multicenter studies for better stratification of same-stage LUAD patients.<br /><br />Overall, the findings emphasize the need to recognize the extent of visceral pleural invasion in LUAD as a critical factor influencing survival outcomes.

Asset Subtitle

Stylianos Korasidis

Meta Tag

Speaker Stylianos Korasidis

Topic Local-Regional Non-small Cell Lung Cancer

Keywords

visceral pleural invasion

lung adenocarcinoma

PL1 invasion

PL2 invasion

prognostic significance

overall survival

cancer-specific survival

disease-free survival

high-grade differentiation

lymphovascular invasion