Blood vessel invasion (BVI) in curatively (R0) resected stage II and IIIA non-small cell lung (NSCLC) cancer patients.

Abstract

e17536 Background: A single center study was conducted to identify the prognostic and predictive value of blood vessel invasion (BVI) in surgically R0 resected stage II and IIIA non-small cell lung cancer patients. Methods: A total of N=105 consecutive patients who had undergone complete (R0) resection for stage II/IIIA primary non-small cell lung cancer (NSCLC) between 01/2008 and 12/2010 at the Lung Cancer Center Nuremberg were evaluated. All pathological specimens were examined for evidence of BVI. All patients were followed for tumour recurrence and survival. Differences between groups were calculated with Chi-square test. Recurrence and survival data were analyzed for all patients using Kaplan-Meier test. Significance was univaratiately calculated by log-rank and multivariately by Cox-regression analysis. Results: The baseline clinical data showed no significant differences between patients with adjuvant chemotherapy (aCTx; cisplatin/vinorelbine; N=46) and without aCTx (N=59) beside of age (aCTx treated patients were younger p=0.03). Demographic data were as follows: male 64%; age <65 years 53%; ECOG 0/1/2 (47%/35%/3%); histology AC/SCC/other (53%/37%/10%); stage IIA/IIB/IIIA (13%/31%/55%); BVI 29%; pneumonectomy 19%. ECOG-PS 0 and no BVI were positive prognostic factors for both recurrence free survival (RFS) and overall survival (OS) in the group without aCTx and remained independent prognostic factors in the multivariate analysis (p<0.001; p=0.002). Additionally, ECOG-PS 0 and no BVI were independent predictive factors for RFS and OS in the aCTx treated group. Conclusions: BVI is an independent prognostic and predictive factor in R0 resected stage II/IIIA NSCLC patients. This subset of patients may have a greater benefit from aCTx and may need to be followed-up more closely.