Impact of Pathological Lymphovascular Invasion of Lung Adenocarcinoma after Induction Chemoradiotherapy.

PURPOSE: We investigated the clinical significance of lymphovascular invasion (LVI) in locally advanced lung adenocarcinoma after induction chemoradiotherapy (CRT).

METHODS

We retrospectively reviewed patients with completely resected lung adenocarcinoma after induction CRT from 2007 to 2021 at our institution. We evaluated the effects of LVI on recurrence-free survival (RFS) and overall survival (OS).

RESULTS

Fifty-six patients were included. The reasons for induction CRT were superior sulcus tumor (n = 11, 19.6%), direct invasion of other organs (n = 7, 12.5%), bulky N1 (n = 3, 5.4%), and N2 (n = 35, 62.5%). A pathological complete response was observed in 6 patients (10.7%). LVI was present in 14 patients (25.0%) and absent in 42 (75.0%). The LVI-positive group had significantly worse 5-year RFS (7.8% vs. 49.7%, p <0.001) and OS (35.2% vs. 73.5%, p = 0.003) than the LVI-negative group. Multivariate analysis revealed that LVI was a significant prognostic factor for both RFS (hazard ratio [HR], 3.91; 95% confidence interval [CI], 1.64-9.32, p = 0.002) and OS (HR, 5.75; 95% CI, 1.92-17.20, p = 0.002).

CONCLUSIONS

LVI can be a poor prognostic factor and an important biomarker for assessing the effectiveness of multimodal treatment in lung adenocarcinoma.