Prognostic impact of lymphatic invasion for pathological stage I squamous cell carcinoma of the lung.

Abstract

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. 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. 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. 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.