P. Macchiarini et al., PROGNOSTIC-SIGNIFICANCE OF PERITUMOURAL BLOOD AND LYMPHATIC VESSEL INVASION BY TUMOR-CELLS IN T4 NONSMALL CELL LUNG-CANCER FOLLOWING INDUCTION THERAPY, Surgical oncology, 4(2), 1995, pp. 91-99
We investigated the impact of new biological prognostic factors in 28
patients receiving a median of two courses of cisplatin-based chemothe
rapy with (n = 14) or without (n = 14) radiation and operation for sta
ge IIIB (T4) non-small cell lung cancer (NSCLC). After induction thera
py, 5 patients had a complete and 21 a partial response; 2 had a stabl
e disease. A complete resection was made in 26 patients (93%). Five pa
tients (18%) had their primary tumour and involved vestiges completely
sterilized. In the remaining 23, the majority of the tumours showed a
bnormalities in the p53 gene expression (56%), harboured proliferating
cells (91%) and induced angiogenesis (91%). Peritumoural blood and ly
mphatic vessel invasion (PBLVI) by tumour emboli was observed in 6 tum
ours. With a median follow-up of 25 months, overall 3-year survival wa
s 48%; disease-free survival (DFS) has not been reached yet. The only
significant factor influencing DFS in multivariate analysis was PBLVI
by tumour cells; PBLVI-positive patients had a significantly higher li
kelihood ratio (P = 0.000001) of developing metastasis than their PBLV
I-negative counterparts. This study documents the prognostic implicati
on of PBLVI by tumour cells in T4 NSCLC.