title: Prognostic impact of pleural invasion in 1488 patients with surgically resected non-small cell lung carcinoma.
abstract: OBJECTIVE
  This study aimed to verify the prognostic impact of pleural invasion according to the revised TNM classification, seventh edition.
  
  
  METHODS
  The study consisted of 1488 patients with surgically resected non-small cell carcinoma. The degree (pl0-3) and location of pleural invasion were examined using hematoxylin and eosin- and elastica van Gieson-stained slides, and outcome was compared with stratification by several clinicopathological factors.
  
  
  RESULTS
  The 5-year overall survival rates of 1008, 260, 85 and 135 patients with pl0, pl1, pl2 and pl3 tumours were 80, 60, 55 and 52%, respectively. Overall survival differed significantly between patients with pl0 tumours and those with pl1 tumours (P < 0.0001). The difference was significant for patients with 1<≤ 2 cm (P = 0.004), 2<≤ 3 cm (P = 0.003) and 3<≤ 5 cm (P = 0.02) tumours. The overall survival of pl0 patients was also significantly better in patients with adenocarcinoma (P < 0.0001) than squamous cell carcinoma (P = 0.043). The overall survival of pl0 patients was significantly better in patients without lymph node metastasis (P < 0.0001) than in those with lymph node metastasis. The 5-year overall survival rates of patients with interlobar, lateral, mediastinal and diaphragmatic pl3 tumours were 65, 51, 51 and 40%, respectively. Overall survival did not differ significantly among these four groups.
  
  
  CONCLUSIONS
  Outcome differs between patients with pl0 tumours and those with pl1-3 tumours, particularly among patients with 1<≤ 2 cm, 2 <≤ 3 cm and 3<≤ 5 cm tumours, adenocarcinoma histology and no lymph node metastasis. The location of pl3 pleural invasion did not affect outcome significantly.
authors.affiliation: Department of Pathology and Clinical Laboratory, National Cancer Center Hospital, Tokyo, Japan.
authors.forename: Mayumi
authors.initials: M
authors.lastname: Oyama
authors.forename: Akiko
authors.initials: A
authors.lastname: Miyagi Maeshima
authors.forename: Naobumi
authors.initials: N
authors.lastname: Tochigi
authors.forename: Koji
authors.initials: K
authors.lastname: Tsuta
authors.forename: Riken
authors.initials: R
authors.lastname: Kawachi
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Sakurai
authors.forename: Shunichi
authors.initials: S
authors.lastname: Watanabe
authors.forename: Hisao
authors.initials: H
authors.lastname: Asamura
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Tsuda
mesh_terms: D000230:Adenocarcinoma / Q000556:secondary / Q000601:surgery; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002289:Carcinoma, Non-Small-Cell Lung / Q000556:secondary* / Q000601:surgery*; D002294:Carcinoma, Squamous Cell / Q000378:metabolism / Q000601:surgery; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008175:Lung Neoplasms / Q000473:pathology* / Q000601:surgery*; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D009367:Neoplasm Staging; D010997:Pleural Neoplasms / Q000556:secondary*; D011013:Pneumonectomy; D011237:Predictive Value of Tests; D011379:Prognosis; D013194:Staining and Labeling / Q000379:methods