Arterial invasion predicts early mortality in stage I non-small cell lung cancer.
BACKGROUND
A retrospective study was performed to evaluate the association between arterial invasion and survival in patients with stage I non-small cell lung cancer.


METHODS
One hundred patients were identified who had undergone complete anatomic resection as definitive treatment for stage I non-small cell lung cancer. The tumors were reviewed for the presence or absence of arterial invasion. Five-year survival data were obtained for all patients.


RESULTS
The 100 patients had an overall 5-year survival of 61%. There were 64 stage IA patients with a 62% 5-year survival and 36 stage IB patients with a 58% 5-year survival. The 39 patients identified with arterial invasion had a 38% 5-year survival compared with a 73% 5-year survival in the 61 patients without arterial invasion (p < 0.001), with an unadjusted hazard ratio of 3.5 (p < 0.001). Multivariate analysis by stage IA versus IB and by size greater or less than 2 cm demonstrated hazard ratios of 3.5 and 4.0, respectively (p < 0.001). This difference was independent of demographic characteristics, tumor type, or grade. Subgroup analysis revealed a hazard ratio of 5.8 in patients with stage IA non-small cell lung cancer (p < 0.001) and 19.8 in patients with tumors < or = 2 cm (p = 0.006).


CONCLUSIONS
Arterial invasion is present in a substantial percentage of patients with stage I non-small cell lung cancer and is adversely associated with survival.
Pechet
Taine T V
TT
Division of Thoracic Surgery, Thomas Jefferson University, Philadelphia, Pennsylvania, USA. taine.pechet@uphs.upenn.edu
Carr
Shamus R
SR
Collins
Joshua E
JE
Cohn
Herbert E
HE
Farber
John L
JL
D000368:Aged; D001158:Arteries / Q000473:pathology*; D002289:Carcinoma, Non-Small-Cell Lung / Q000401:mortality / Q000473:pathology* / Q000601:surgery / Q000628:therapy; D003131:Combined Modality Therapy; D015897:Comorbidity; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D015993:Life Tables; D008175:Lung Neoplasms / Q000401:mortality / Q000473:pathology* / Q000601:surgery / Q000628:therapy; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D009367:Neoplasm Staging; D011379:Prognosis; D016016:Proportional Hazards Models; D012042:Registries; D012189:Retrospective Studies; D016879:Salvage Therapy; D016019:Survival Analysis; D015996:Survival Rate