title: Prognostic impact of lymphatic invasion for pathological stage I squamous cell carcinoma of the lung.
abstract: OBJECTIVE
  The purpose of this study was to investigate the prognostic factors for pathological stage I squamous cell carcinoma of the lung to aid decisions regarding adjuvant chemotherapy.
  
  
  METHODS
  We retrospectively analyzed data from 114 consecutive patients with completely resected pathological stage I squamous cell carcinoma of the lung by lobectomy or segmentectomy with systematic lymphadenectomy.
  
  
  RESULTS
  The median tumor size was 2.9 cm. Lymphatic, vascular, and pleural invasions were present in 39 (34.2%), 50 (43.9%), and 25 (21.9%) patients, respectively. There were significant differences in recurrence-free and overall survival between patients with and without lymphatic invasion (P = 0.044 and P = 0.040, respectively). Multivariate Cox proportional hazards models demonstrated that postoperative complications (hazard ratio 3.37, 95% confidence interval 1.53-7.42, P = 0.003) and lymphatic invasion (hazards ratio 2.76, 95% confidence interval 1.26-6.04, P = 0.011) were independent prognostic factors influencing recurrence-free survival. Furthermore, age (hazard ratio 1.10, 95% confidence interval 1.02-1.18, P = 0.013) and lymphatic invasion (hazard ratio 3.54, 95% confidence interval 1.33-9.42, P = 0.011) were independent prognostic factors influencing overall survival.
  
  
  CONCLUSIONS
  Lymphatic invasion is an independent prognostic factor influencing both recurrence-free and overall survival in patients with pathological stage I squamous cell carcinoma of the lung. Patients with lymphatic invasion may be candidates for adjuvant chemotherapy.
authors.affiliation: Department of Surgical Oncology, Research Institute for Radiation Biology and Medicine, Hiroshima University, 1-2-3-Kasumi, Minami-ku, Hiroshima City, Hiroshima, 734-0037, Japan.
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Tsutani
authors.forename: Yoshihiro
authors.initials: Y
authors.lastname: Miyata
authors.forename: Takeshi
authors.initials: T
authors.lastname: Mimura
authors.forename: Kei
authors.initials: K
authors.lastname: Kushitani
authors.forename: Yukio
authors.initials: Y
authors.lastname: Takeshima
authors.forename: Masahiro
authors.initials: M
authors.lastname: Yoshimura
authors.forename: Morihito
authors.initials: M
authors.lastname: Okada
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000401:mortality / Q000556:secondary* / Q000601:surgery; D017024:Chemotherapy, Adjuvant; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000401:mortality / Q000473:pathology* / Q000601:surgery; D008197:Lymph Node Excision / Q000379:methods*; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D009367:Neoplasm Staging; D011013:Pneumonectomy; D011183:Postoperative Complications; D011379:Prognosis; D012189:Retrospective Studies; D015996:Survival Rate