Clinical impact of visceral pleural, lymphovascular and perineural invasion in completely resected non-small cell lung cancer

OBJECTIVES: This study is conducted to show the relationship between visceral pleural, lymphovascular, and perineural invasion, and other clinicopathologic characteristics and their significance as prognostic factors. METHODS: The clinicopathologic characteristics of 289 patients who underwent a potentially curative surgical resection between 2000 and 2009 in our clinic were reviewed retrospectively. The prognostic factors were then evaluated by univariate and multivariate analysis. The patients who were given neoadjuvant-adjuvant chemotherapy and/or radiotherapy and who died due to postoperative mortality were excluded. Data from 188 patients were analyzed. RESULTS: Out of the 188 patients (108 diagnosed as adenocarcinoma and 80 squamous cell carcinoma), 66 patients had lymphovascular invasion, 53 patients had perineural invasion, and 92 patients had visceral pleural invasion. Visceral pleural invasion was related with T factor, tumor histology, dimension, stage, and differentiation. Lymphovascular invasion was related with N status and stage. Perineural invasion was observed more frequently in tumors with moderate/poor differentiation. Visceral pleural and lymphovascular invasion were found to be poor prognostic factors but we could not show statistically meaningful effect of perineural invasion on survival. CONCLUSION: The presence of visceral pleural or lymphovascular invasion can show higher risk of mortality whereas perineural invasion has no effect on prognosis.