Visceral pleural invasion (VPI), an aggressive and invasive factor, may have an impact on survival in node-negative non-small cell lung cancer (NSCLC), according to an article published in Chest.1
Investigators conducted a meta-analysis with 13 relevant studies that included 27,171 patients with node-negative NSCLC, and 21% had VPI. VPI had a significant impact on 5-year overall survival (OS) in patients with tumor size ≤3 cm (odds ratio [OR], 0.71: 95% CI, .64-.79; P<.001), >3 but ≤5 cm (OR, .69; 95% CI, .56-.86; P<.001), and >5 but ≤7 cm (OR, .70; 95% CI, .54-.91; P=.007).
When compared to stage 1B NSCLC, tumor size ≤3 cm plus VPI displayed improved survival over tumor size >3 but ≤5 cm independent of VPI presence (OR, 1.31; 95% CI, 1.19-1.45; P<.001).
RELATED: FDA Approves Pembrolizumab for Metastatic Non-Small Cell Lung Cancer
In an exploratory analysis, tumor size ≤3 cm plus VPI did not possess a significant OS benefit over tumor size >3 but ≤5 cm without VPI (OR, 1.16; 95% CI, .95-1.43; P=.15) but was associated with a better prognosis.
Authors concluded that because VPI and tumor size can synergistically impact survival in node-negative NSCLC, adjuvant chemotherapy after surgical resection may be considered in patients with stage 1B NSCLC. Additional clinical trials are required to investigate this further.
- Long J, Liang W, Shen J, et al. The impact of visceral pleural invasion in node-negative non-small cell lung cancer: a systematic review and meta-analysis. Chest. 2015;148(4):903-911.