Re-evaluation of the prognostic value of visceral pleura invasion in Stage IB non-small cell lung cancer using the prospective multicenter ACOSOG Z0030 trial data set
Abstract Purpose This study seeks to clarify the modern prognostic significance of visceral pleura invasion (VPI) in Stage IB (T2aN0M0) non-small cell lung cancer (NSCLC) within the context of the 7th edition TNM classification using the data set from a recent prospective multicenter trial. Patients...
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| creator | Fibla, Juan J Cassivi, Stephen D Brunelli, Alessandro Decker, Paul A Allen, Mark S Darling, Gail E Landreneau, Rodney J Putnam, Joe B |
| description | Abstract Purpose This study seeks to clarify the modern prognostic significance of visceral pleura invasion (VPI) in Stage IB (T2aN0M0) non-small cell lung cancer (NSCLC) within the context of the 7th edition TNM classification using the data set from a recent prospective multicenter trial. Patients and methods 1111 early-stage NSCLC patients participating in the ACOSOG Z0030 trial (1990–2004) underwent curative pulmonary resection. After excluding T2b tumours (>5 cm and ≤7 cm) and non-size-based T2 factors other than VPI, 289 patients were categorized as Stage IB NSCLC – T2aN0M0 – according to the AJCC 7th edition classification. The patients were divided into three groups according to size and VPI: tumours ≤ 3 cm with VPI (Group I, “VPI-alone”, n = 83), tumours > 3 cm and ≤5 cm without VPI (Group II, “Size-alone”, n = 156), and tumours > 3 cm and ≤5 cm with VPI (Group III, “VPI + Size”, n = 50). Multivariate Cox regression analysis was used to assess the association of VPI and size with survival, adjusting for age, gender, histology and type of resection. Results VPI in Stage IB was identified in 133 patients (46.0%). Survival analysis in these patients identified an optimal cutpoint for survival based on size of 3.1 cm. Group III (VPI + Size) had a 5-year survival rate of 55.0% significantly shorter when compared to Group I (VPI-alone = 68.3%, p = 0.009), and Group II (Size-alone = 67.2%, p = 0.021). No difference was found between Groups I and II. Multivariable analysis showed that VPI associated with size was an independent negative prognostic factor of long-term survival, along with older age and limited resection. Conclusions Stage IB patients with VPI and tumours >3 cm and ≤5 cm have significantly worse prognosis than those with ‘T2a’ tumours on the basis of VPI or tumour size alone. This finding would suggest upstaging these patients from the current IB status to Stage IIA. |
| doi_str_mv | 10.1016/j.lungcan.2012.09.010 |
| format | Article |
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Patients and methods 1111 early-stage NSCLC patients participating in the ACOSOG Z0030 trial (1990–2004) underwent curative pulmonary resection. After excluding T2b tumours (>5 cm and ≤7 cm) and non-size-based T2 factors other than VPI, 289 patients were categorized as Stage IB NSCLC – T2aN0M0 – according to the AJCC 7th edition classification. The patients were divided into three groups according to size and VPI: tumours ≤ 3 cm with VPI (Group I, “VPI-alone”, n = 83), tumours > 3 cm and ≤5 cm without VPI (Group II, “Size-alone”, n = 156), and tumours > 3 cm and ≤5 cm with VPI (Group III, “VPI + Size”, n = 50). Multivariate Cox regression analysis was used to assess the association of VPI and size with survival, adjusting for age, gender, histology and type of resection. Results VPI in Stage IB was identified in 133 patients (46.0%). Survival analysis in these patients identified an optimal cutpoint for survival based on size of 3.1 cm. Group III (VPI + Size) had a 5-year survival rate of 55.0% significantly shorter when compared to Group I (VPI-alone = 68.3%, p = 0.009), and Group II (Size-alone = 67.2%, p = 0.021). No difference was found between Groups I and II. Multivariable analysis showed that VPI associated with size was an independent negative prognostic factor of long-term survival, along with older age and limited resection. Conclusions Stage IB patients with VPI and tumours >3 cm and ≤5 cm have significantly worse prognosis than those with ‘T2a’ tumours on the basis of VPI or tumour size alone. This finding would suggest upstaging these patients from the current IB status to Stage IIA.</description><identifier>ISSN: 0169-5002</identifier><identifier>EISSN: 1872-8332</identifier><identifier>DOI: 10.1016/j.lungcan.2012.09.010</identifier><identifier>PMID: 23040416</identifier><identifier>CODEN: LUCAE5</identifier><language>eng</language><publisher>Oxford: Elsevier Ireland Ltd</publisher><subject>7th edition TNM classification ; Adenocarcinoma - mortality ; Adenocarcinoma - pathology ; Adenocarcinoma - surgery ; Adult ; Aged ; Aged, 80 and over ; Biological and medical sciences ; Carcinoma, Non-Small-Cell Lung - mortality ; Carcinoma, Non-Small-Cell Lung - pathology ; Carcinoma, Non-Small-Cell Lung - surgery ; Female ; Hematology, Oncology and Palliative Medicine ; Humans ; Kaplan-Meier Estimate ; Lung Neoplasms - mortality ; Lung Neoplasms - pathology ; Lung Neoplasms - surgery ; Lymph Node Excision ; Male ; Medical sciences ; Middle Aged ; Multicenter Studies as Topic ; Multivariate Analysis ; Neoplasm Invasiveness ; Neoplasm Staging ; Non-small cell lung cancer ; Pleura - pathology ; Pneumology ; Prognosis ; Prognostic factor ; Proportional Hazards Models ; Prospective Studies ; Pulmonary/Respiratory ; Randomized Controlled Trials as Topic ; Tumors ; Tumors of the respiratory system and mediastinum ; Visceral pleura</subject><ispartof>Lung cancer (Amsterdam, Netherlands), 2012-12, Vol.78 (3), p.259-262</ispartof><rights>Elsevier Ireland Ltd</rights><rights>2012 Elsevier Ireland Ltd</rights><rights>2015 INIST-CNRS</rights><rights>Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c552t-9084e3ef8b6edde32ff2432cd547fc775e34c65bc3f1c4d7796c65d1d679d253</citedby><cites>FETCH-LOGICAL-c552t-9084e3ef8b6edde32ff2432cd547fc775e34c65bc3f1c4d7796c65d1d679d253</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/j.lungcan.2012.09.010$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>230,314,780,784,885,3550,27924,27925,45995</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=26606847$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/23040416$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Fibla, Juan J</creatorcontrib><creatorcontrib>Cassivi, Stephen D</creatorcontrib><creatorcontrib>Brunelli, Alessandro</creatorcontrib><creatorcontrib>Decker, Paul A</creatorcontrib><creatorcontrib>Allen, Mark S</creatorcontrib><creatorcontrib>Darling, Gail E</creatorcontrib><creatorcontrib>Landreneau, Rodney J</creatorcontrib><creatorcontrib>Putnam, Joe B</creatorcontrib><title>Re-evaluation of the prognostic value of visceral pleura invasion in Stage IB non-small cell lung cancer using the prospective multicenter ACOSOG Z0030 trial data set</title><title>Lung cancer (Amsterdam, Netherlands)</title><addtitle>Lung Cancer</addtitle><description>Abstract Purpose This study seeks to clarify the modern prognostic significance of visceral pleura invasion (VPI) in Stage IB (T2aN0M0) non-small cell lung cancer (NSCLC) within the context of the 7th edition TNM classification using the data set from a recent prospective multicenter trial. Patients and methods 1111 early-stage NSCLC patients participating in the ACOSOG Z0030 trial (1990–2004) underwent curative pulmonary resection. After excluding T2b tumours (>5 cm and ≤7 cm) and non-size-based T2 factors other than VPI, 289 patients were categorized as Stage IB NSCLC – T2aN0M0 – according to the AJCC 7th edition classification. The patients were divided into three groups according to size and VPI: tumours ≤ 3 cm with VPI (Group I, “VPI-alone”, n = 83), tumours > 3 cm and ≤5 cm without VPI (Group II, “Size-alone”, n = 156), and tumours > 3 cm and ≤5 cm with VPI (Group III, “VPI + Size”, n = 50). Multivariate Cox regression analysis was used to assess the association of VPI and size with survival, adjusting for age, gender, histology and type of resection. Results VPI in Stage IB was identified in 133 patients (46.0%). Survival analysis in these patients identified an optimal cutpoint for survival based on size of 3.1 cm. Group III (VPI + Size) had a 5-year survival rate of 55.0% significantly shorter when compared to Group I (VPI-alone = 68.3%, p = 0.009), and Group II (Size-alone = 67.2%, p = 0.021). No difference was found between Groups I and II. Multivariable analysis showed that VPI associated with size was an independent negative prognostic factor of long-term survival, along with older age and limited resection. Conclusions Stage IB patients with VPI and tumours >3 cm and ≤5 cm have significantly worse prognosis than those with ‘T2a’ tumours on the basis of VPI or tumour size alone. This finding would suggest upstaging these patients from the current IB status to Stage IIA.</description><subject>7th edition TNM classification</subject><subject>Adenocarcinoma - mortality</subject><subject>Adenocarcinoma - pathology</subject><subject>Adenocarcinoma - surgery</subject><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Biological and medical sciences</subject><subject>Carcinoma, Non-Small-Cell Lung - mortality</subject><subject>Carcinoma, Non-Small-Cell Lung - pathology</subject><subject>Carcinoma, Non-Small-Cell Lung - surgery</subject><subject>Female</subject><subject>Hematology, Oncology and Palliative Medicine</subject><subject>Humans</subject><subject>Kaplan-Meier Estimate</subject><subject>Lung Neoplasms - mortality</subject><subject>Lung Neoplasms - pathology</subject><subject>Lung Neoplasms - surgery</subject><subject>Lymph Node Excision</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Multicenter Studies as Topic</subject><subject>Multivariate Analysis</subject><subject>Neoplasm Invasiveness</subject><subject>Neoplasm Staging</subject><subject>Non-small cell lung cancer</subject><subject>Pleura - pathology</subject><subject>Pneumology</subject><subject>Prognosis</subject><subject>Prognostic factor</subject><subject>Proportional Hazards Models</subject><subject>Prospective Studies</subject><subject>Pulmonary/Respiratory</subject><subject>Randomized Controlled Trials as Topic</subject><subject>Tumors</subject><subject>Tumors of the respiratory system and mediastinum</subject><subject>Visceral pleura</subject><issn>0169-5002</issn><issn>1872-8332</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2012</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFUstuEzEUHSEQDYVPAHmDxGbCtT2PeFPURlAqVYpEumJjOZ47qYPjCfbMSP0hvpM7SiiPDbJky_Y55x7f4yx7zWHOgVfvd3M_hK01YS6AizmoOXB4ks34ohb5QkrxNJsRTuUlgDjLXqS0A-A1B_U8OxMSCih4Nct-fMEcR-MH07susK5l_T2yQ-y2oUu9s2y6w-l8dMliNJ4dPA7RMBdGkyaOC2zdmy2ymysWupCnvfGeWaRpssjIIxHZkBxtTurpgLZ3I7L94KkKhp4Ql8vVenXNvgJIYH10VKsxvWEJ-5fZs9b4hK9O63l29-nj3fJzfru6vlle3ua2LEWfK1gUKLFdbCpsGpSibUUhhW3Kom5tXZcoC1uVGytbboumrlVF24Y3Va0aUcrz7OIoexg2e2wmX_RifYhub-KD7ozTf98Ed6-33ajLGhQNEnh3Eojd9wFTr_dT27w3Abshac6lqoRQhSRoeYRaakeK2D6W4aCniPVOnyLWU8QalKaIiffmT4-PrF-ZEuDtCWCSNb6N1H-XfuOqCqpFURPuwxGH1NDRYdTJOqSsGhcpHd107r9WLv5RsN4FR0W_4QOmXTfEQGlprhNx9Hr6j9N35AKglErJn58732o</recordid><startdate>20121201</startdate><enddate>20121201</enddate><creator>Fibla, Juan J</creator><creator>Cassivi, Stephen D</creator><creator>Brunelli, Alessandro</creator><creator>Decker, Paul A</creator><creator>Allen, Mark S</creator><creator>Darling, Gail E</creator><creator>Landreneau, Rodney J</creator><creator>Putnam, Joe B</creator><general>Elsevier Ireland Ltd</general><general>Elsevier</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20121201</creationdate><title>Re-evaluation of the prognostic value of visceral pleura invasion in Stage IB non-small cell lung cancer using the prospective multicenter ACOSOG Z0030 trial data set</title><author>Fibla, Juan J ; Cassivi, Stephen D ; Brunelli, Alessandro ; Decker, Paul A ; Allen, Mark S ; Darling, Gail E ; Landreneau, Rodney J ; Putnam, Joe B</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c552t-9084e3ef8b6edde32ff2432cd547fc775e34c65bc3f1c4d7796c65d1d679d253</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2012</creationdate><topic>7th edition TNM classification</topic><topic>Adenocarcinoma - mortality</topic><topic>Adenocarcinoma - pathology</topic><topic>Adenocarcinoma - surgery</topic><topic>Adult</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Biological and medical sciences</topic><topic>Carcinoma, Non-Small-Cell Lung - mortality</topic><topic>Carcinoma, Non-Small-Cell Lung - pathology</topic><topic>Carcinoma, Non-Small-Cell Lung - surgery</topic><topic>Female</topic><topic>Hematology, Oncology and Palliative Medicine</topic><topic>Humans</topic><topic>Kaplan-Meier Estimate</topic><topic>Lung Neoplasms - mortality</topic><topic>Lung Neoplasms - pathology</topic><topic>Lung Neoplasms - surgery</topic><topic>Lymph Node Excision</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Multicenter Studies as Topic</topic><topic>Multivariate Analysis</topic><topic>Neoplasm Invasiveness</topic><topic>Neoplasm Staging</topic><topic>Non-small cell lung cancer</topic><topic>Pleura - pathology</topic><topic>Pneumology</topic><topic>Prognosis</topic><topic>Prognostic factor</topic><topic>Proportional Hazards Models</topic><topic>Prospective Studies</topic><topic>Pulmonary/Respiratory</topic><topic>Randomized Controlled Trials as Topic</topic><topic>Tumors</topic><topic>Tumors of the respiratory system and mediastinum</topic><topic>Visceral pleura</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Fibla, Juan J</creatorcontrib><creatorcontrib>Cassivi, Stephen D</creatorcontrib><creatorcontrib>Brunelli, Alessandro</creatorcontrib><creatorcontrib>Decker, Paul A</creatorcontrib><creatorcontrib>Allen, Mark S</creatorcontrib><creatorcontrib>Darling, Gail E</creatorcontrib><creatorcontrib>Landreneau, Rodney J</creatorcontrib><creatorcontrib>Putnam, Joe B</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Lung cancer (Amsterdam, Netherlands)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Fibla, Juan J</au><au>Cassivi, Stephen D</au><au>Brunelli, Alessandro</au><au>Decker, Paul A</au><au>Allen, Mark S</au><au>Darling, Gail E</au><au>Landreneau, Rodney J</au><au>Putnam, Joe B</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Re-evaluation of the prognostic value of visceral pleura invasion in Stage IB non-small cell lung cancer using the prospective multicenter ACOSOG Z0030 trial data set</atitle><jtitle>Lung cancer (Amsterdam, Netherlands)</jtitle><addtitle>Lung Cancer</addtitle><date>2012-12-01</date><risdate>2012</risdate><volume>78</volume><issue>3</issue><spage>259</spage><epage>262</epage><pages>259-262</pages><issn>0169-5002</issn><eissn>1872-8332</eissn><coden>LUCAE5</coden><abstract>Abstract Purpose This study seeks to clarify the modern prognostic significance of visceral pleura invasion (VPI) in Stage IB (T2aN0M0) non-small cell lung cancer (NSCLC) within the context of the 7th edition TNM classification using the data set from a recent prospective multicenter trial. Patients and methods 1111 early-stage NSCLC patients participating in the ACOSOG Z0030 trial (1990–2004) underwent curative pulmonary resection. After excluding T2b tumours (>5 cm and ≤7 cm) and non-size-based T2 factors other than VPI, 289 patients were categorized as Stage IB NSCLC – T2aN0M0 – according to the AJCC 7th edition classification. The patients were divided into three groups according to size and VPI: tumours ≤ 3 cm with VPI (Group I, “VPI-alone”, n = 83), tumours > 3 cm and ≤5 cm without VPI (Group II, “Size-alone”, n = 156), and tumours > 3 cm and ≤5 cm with VPI (Group III, “VPI + Size”, n = 50). Multivariate Cox regression analysis was used to assess the association of VPI and size with survival, adjusting for age, gender, histology and type of resection. Results VPI in Stage IB was identified in 133 patients (46.0%). Survival analysis in these patients identified an optimal cutpoint for survival based on size of 3.1 cm. Group III (VPI + Size) had a 5-year survival rate of 55.0% significantly shorter when compared to Group I (VPI-alone = 68.3%, p = 0.009), and Group II (Size-alone = 67.2%, p = 0.021). No difference was found between Groups I and II. Multivariable analysis showed that VPI associated with size was an independent negative prognostic factor of long-term survival, along with older age and limited resection. Conclusions Stage IB patients with VPI and tumours >3 cm and ≤5 cm have significantly worse prognosis than those with ‘T2a’ tumours on the basis of VPI or tumour size alone. This finding would suggest upstaging these patients from the current IB status to Stage IIA.</abstract><cop>Oxford</cop><pub>Elsevier Ireland Ltd</pub><pmid>23040416</pmid><doi>10.1016/j.lungcan.2012.09.010</doi><tpages>4</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | 7th edition TNM classification Adenocarcinoma - mortality Adenocarcinoma - pathology Adenocarcinoma - surgery Adult Aged Aged, 80 and over Biological and medical sciences Carcinoma, Non-Small-Cell Lung - mortality Carcinoma, Non-Small-Cell Lung - pathology Carcinoma, Non-Small-Cell Lung - surgery Female Hematology, Oncology and Palliative Medicine Humans Kaplan-Meier Estimate Lung Neoplasms - mortality Lung Neoplasms - pathology Lung Neoplasms - surgery Lymph Node Excision Male Medical sciences Middle Aged Multicenter Studies as Topic Multivariate Analysis Neoplasm Invasiveness Neoplasm Staging Non-small cell lung cancer Pleura - pathology Pneumology Prognosis Prognostic factor Proportional Hazards Models Prospective Studies Pulmonary/Respiratory Randomized Controlled Trials as Topic Tumors Tumors of the respiratory system and mediastinum Visceral pleura |
| title | Re-evaluation of the prognostic value of visceral pleura invasion in Stage IB non-small cell lung cancer using the prospective multicenter ACOSOG Z0030 trial data set |
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