Little Things Make Big Things Happen

• Published in: American journal of clinical pathology Vol. 143; no. 6; pp. 889 - 894
• Main Authors: Marquez-Medina, Diego, Martin-Marco, Antonio, Caldero, Sonia Gatius, Montero-Fernandez, Angeles
• Format: Journal Article
• Language: English
• Published: Oxford, UK Oxford University Press 01-06-2015
• Subjects: Non–small cell lung cancer; Angiolymphatic invasion; Mediastinal lymph node involvement; Induction treatment; Tumor necrosis; Locally advanced
• ISSN: 0002-9173; 1943-7722
• DOI: 10.1309/AJCPYQ8V3BXSWRWG

Objectives:
Size, invasion of thoracic structures, and ipsilateral mediastinal lymph node involvement (pN2) are well-known prognostic factors that configure the staging of resectable, locally advanced non–small cell lung cancer (LA-NSCLC). The prognostic impact of angiolymphatic invasion (ALI) and tumor necrosis (TN) has been barely explored in LA-NSCLC treated with prior induction therapies.
Methods:
We retrospectively reviewed 47 resected LA-NSCLCs treated with a prior platin-based chemotherapy or chemoradiation. The impact of ALI, TN, and other pathologic features on survival was analyzed.
Results:
ALI was presented in 23.4% of cases and TN in 29.8%. Disease-free and overall survival decreased when ALI, TN, or pN2 was present. The incidence of ALI was lower in LA-NSCLC with a good response to induction.
Conclusion:
Our series is the first to report the prognostic impact of ALI and TN in induction-treated LA-NSCLC. The presence of ALI and TN should be included in the pathologic reports.