Clinical Research Papers:

Visceral pleural invasion predict a poor survival among lung adenocarcinoma patients with tumor size ≤ 3cm

Tianxiang Chen, Jizhuang Luo, Rui Wang, Haiyong Gu, Yu Gu, Qingyuan Huang, Yiyang Wang, Jiajie Zheng, Chang Gu, Xufeng Pan, Jun Yang, Yunhai Yang _ and Heng Zhao

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Oncotarget. 2017; 8:66576-66583. https://doi.org/10.18632/oncotarget.16476

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Tianxiang Chen1,*, Jizhuang Luo1,*, Rui Wang1, Haiyong Gu1, Yu Gu2, Qingyuan Huang1, Yiyang Wang1, Jiajie Zheng1, Chang Gu1, Xufeng Pan1, Jun Yang1, Yunhai Yang1 and Heng Zhao1

1 Department of Thoracic Surgery, Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai, China

2 Department of Radiation Oncology, Shanghai Cancer Hospital, Fudan University, Shanghai, China

* These authors have contributed equally to this work

Correspondence to:

Yunhai Yang, email:

Heng Zhao, email:

Keywords: invasive lung adenocarcinoma, non-small cell lung cancer, VPI, stage I

Received: February 08, 2017 Accepted: March 14, 2017 Published: March 22, 2017


Introduction: The impact of visceral pleural invasion (VPI) on survival remains controversial for patients with early stage non-small cell lung cancer (NSCLC). This study investigated the survival status of VPI among patients with lymph node-negative lung invasive adenocarcinoma smaller than 3cm.

Methods: We retrospectively reviewed 2537 consecutive patients with pathologic stage I lung invasive adenocarcinoma. All patients had received lobectomy and system lymph nodes resection.

Patients were classified into 4 groups according to tumor size and visceral pleural invasion status. Disease-free survival (DFS) and overall survival (OS) were analyzed to evaluate survival difference between these groups.

Results: 548 patients with VPI while 1989 patients without VPI were included in this study. For patients with tumor size ≤2cm, patients with VPI had significant worse DFS (HR,4.85; 95% CI, 2.98-7.91; p = .000) and OS(HR,3.52; 95% CI, 1.59-7.78; p = .002) compared with non-VPI group. For patients with tumor size between 2-3cm, patients with VPI had significant worse DFS (HR, 1.72; 95% CI, 1.16-2.55; p = .006) but no significant OS (HR, 1.31; 95% CI, 0.76-2.24; p = .330) compared with non-VPI group. For patients with VPI, there were no survival difference between tumor size 2-3cm group and ≤2cm group for both DFS(HR,1.02; 95% CI, 0.65-1.61; p = .939) and OS(HR,1.45; 95% CI, 0.71-2.97; p = .315).

Conclusions: VPI could predict a poor survival even for node-negative invasive lung adenocarcinoma patients with tumor size less than 3cm.

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