Extratumoral lymphatic permeation as prognostic marker in NSCLC

Matsumura and colleagues from the National Cancer Center Hospital East in Chiba, Japan recently reported in the Journal of Thoracic Oncology (abstract) their study of the location of lymphatic permeation in relation to the tumor and the effect on outcome. Since 2001, this group has been classifying lymphatic permeation in patients with resected NSCLC into 3 catagories: no lymphatic permeation (ly0), intratumoral permeation (ly1), and extratumoral permeation (ly2).  This is a follow-up to a previous study reported in 2007 that found that NSCLC patients with ly2 developed more recurrence than patients with ly1--but long-term follow-up was short. A couple of practical notes from their methods-- All cut surfaces containing the main tumor were submitted for histology.  Victoria blue/van Gieson stain was performed on all tumor sections to evaluate for vascular invasion, lymphatic invasion, and pleural invasion and lymphatic invasion was confirmed by immunohistochemical staining for podoplanin (D2-40). One thing that makes this study valuable is that 67% of patients included in this study were pT1, although it is noted that the median tumor size was 2.8 cm.  Another is that median follow-up was 85 months. 5-year overall survival (5yOS) was significantly worse for ly2 (34%) versus ly0 (75%) and ly1 (63%).  Both recurrence-free survival (RFS) and cancer-specific survival were also similarly worse between ly2 and ly0 and ly1 groups.  Similar si...
Source: The Daily Sign-Out - Category: Pathologists Authors: Source Type: blogs