title: Influence of visceral pleural invasion on survival in completely resected non-small-cell lung cancer.
abstract: OBJECTIVE
  Although the prognostic implications of visceral pleural invasion (VPI) are well established, it remains controversial whether the extent of VPI affects survival in patients with completely resected non-small-cell lung cancer (NSCLC). In addition, the impact of VPI according to nodal status is unclear. We evaluated the influence of the extent of pleural invasion on survival by analysing a multicentre retrospective database of patients who had undergone surgery for NSCLC.
  
  
  METHODS
  We retrospectively reviewed the clinicopathological characteristics and outcomes of 639 patients with NSCLC who underwent anatomic complete resection from 2005 to 2007 at nine hospitals affiliated with the Yokohama Consortium of Thoracic Surgeons.
  
  
  RESULTS
  The median follow-up was 65.0 months. The extent of pleural invasion was PL0 in 462 patients, PL1 in 135 and PL2 in 42. The 5-year overall survival rate was significantly higher in patients with PL0 tumours (75.9%) than in those with PL1 (63.6%) or PL2 tumours (54.1%). On subgroup analysis according to nodal status, PL0 was associated with a higher survival rate than that of PL1 or PL2 tumours in patients with N0 or N1 metastasis, but not in those with N2 metastasis. There was no difference between PL1 and PL2 in any subgroup.
  
  
  CONCLUSIONS
  Our results suggest that the presence of VPI, rather than the extent, has an impact on postoperative survival in patients with NSCLC who have N0 or N1 metastasis. Because very few previous studies have addressed the effects of VPI in patients with N1 disease, further re-evaluation of the prognostic impact of VPI is necessary in this subgroup of patients.
authors.affiliation: Department of Surgery, Yokohama City University, Yokohama, Japan adachi-fam@m2.gyao.ne.jp.
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Adachi
authors.affiliation: Department of Surgery, Yokohama City University, Yokohama, Japan.
authors.forename: Masahiro
authors.initials: M
authors.lastname: Tsuboi
authors.affiliation: Department of Surgery, Yokohama City University, Yokohama, Japan.
authors.forename: Teppei
authors.initials: T
authors.lastname: Nishii
authors.affiliation: Department of Surgery, Yokohama City University, Yokohama, Japan.
authors.forename: Taketsugu
authors.initials: T
authors.lastname: Yamamoto
authors.affiliation: Department of Surgery, Yokohama City University, Yokohama, Japan.
authors.forename: Takuya
authors.initials: T
authors.lastname: Nagashima
authors.affiliation: Department of Surgery, Yokohama City University, Yokohama, Japan.
authors.forename: Kohei
authors.initials: K
authors.lastname: Ando
authors.affiliation: Department of Surgery, Yokohama City University, Yokohama, Japan.
authors.forename: Yoshihiro
authors.initials: Y
authors.lastname: Ishikawa
authors.affiliation: Department of Surgery, Yokohama City University, Yokohama, Japan.
authors.forename: Tekkan
authors.initials: T
authors.lastname: Woo
authors.affiliation: Department of Surgery, Yokohama City University, Yokohama, Japan.
authors.forename: Katsuya
authors.initials: K
authors.lastname: Watanabe
authors.affiliation: Department of Surgery, Yokohama City University, Yokohama, Japan.
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Kumakiri
authors.affiliation: Department of Surgery, Yokohama City University, Yokohama, Japan.
authors.forename: Takamitsu
authors.initials: T
authors.lastname: Maehara
authors.affiliation: Department of Surgery, Yokohama City University, Yokohama, Japan.
authors.forename: Takao
authors.initials: T
authors.lastname: Morohoshi
authors.affiliation: Department of Surgery, Yokohama City University, Yokohama, Japan.
authors.forename: Haruhiko
authors.initials: H
authors.lastname: Nakayama
authors.affiliation: Department of Surgery, Yokohama City University, Yokohama, Japan.
authors.forename: Munetaka
authors.initials: M
authors.lastname: Masuda
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002289:Carcinoma, Non-Small-Cell Lung / Q000453:epidemiology / Q000401:mortality / Q000473:pathology* / Q000601:surgery*; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000453:epidemiology / Q000401:mortality / Q000473:pathology* / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D010994:Pleura / Q000473:pathology; D012189:Retrospective Studies
keywords: Non-small-cell lung cancer; Postoperative; Visceral pleura; Visceral pleural invasion