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• W2010317100 abstract "To the Editor: We read with great interest the article by Shimizu and colleagues1Shimizu K. Yoshida J. Nagai K. Nishimura M. Ishii G. Morishita Y. et al.Visceral pleural invasion is an invasive and aggressive indicator of non-small cell lung cancer.J Thorac Cardiovasc Surg. 2005; 130: 160-165Abstract Full Text Full Text PDF PubMed Scopus (140) Google Scholar published in the July 2005 issue of the Journal. They found that visceral pleural invasion (VPI) is a significant poor prognostic factor of non–small cell lung cancer (NSCLC), regardless of N status. Stage I NSCLC has been subdivided into IA (T1N0M0) and IB (T2N0M0) based on tumor size (3 cm as a cutoff value) and non–size-based T2 descriptors (including VPI, hilar atelectasis, and obstructive pneumonitis).2Mountain C.F. Revisions in the international system for staging lung cancer.Chest. 1997; 111: 1710-1717Crossref PubMed Scopus (4413) Google Scholar Although a poor prognostic effect of VPI has generally been reported, its prognostic value for survival has remained controversial.3Martini N. Bains M.S. Burt M.E. Zakowski M.F. McCormack P. Rusch V.W. et al.Incidence of local recurrence and second primary tumors in resected stage I lung cancer.J Thorac Cardiovasc Surg. 1995; 109: 120-129Abstract Full Text Full Text PDF PubMed Scopus (825) Google Scholar, 4López-Encuentra A. Gómez de la Cámara A. Rami-Porta R. Duque-Medina J.L. de Nicolás J.L. Sayas J; Bronchogenic Carcinoma Cooperative Group of the Spanish Society of Pneumology and Thoracic Surgery (GCCB-S). Previous tumour as a prognostic factor in stage I non-small cell lung cancer.Thorax. 2007; 62: 386-390Crossref PubMed Scopus (23) Google Scholar Shimizu and colleagues1Shimizu K. Yoshida J. Nagai K. Nishimura M. Ishii G. Morishita Y. et al.Visceral pleural invasion is an invasive and aggressive indicator of non-small cell lung cancer.J Thorac Cardiovasc Surg. 2005; 130: 160-165Abstract Full Text Full Text PDF PubMed Scopus (140) Google Scholar have demonstrated that both VPI and tumor size had a significant impact on survival for patients with NSCLC in univariate analysis. However, tumor size failed to be a predictor of survival in multivariate analysis, whereas VPI was still a significant predictor for all patients with NSCLC (P < .001) and those with stage I disease (P = .0104). VPI overwhelmed tumor size as a prognostic factor for NSCLC in their study. However, most studies in the literature have reported tumor size as a significant prognostic factor in NSCLC. The International Association for the Study of Lung Cancer Lung Cancer Staging Project Committee has recommended that T1 tumors be classified as T1a (≤2 cm) and T1b (>2 to ≤3 cm) and that T2 tumors be classified as T2a (>3 to ≤5 cm), T2b (>5 to ≤7 cm), and T3 (>7 cm).5Rami-Porta R. Ball D. Crowley J. Giroux D.J. Jett J. Travis W.D. et al.The IASLC Lung Cancer Staging Project: proposals for the revision of the T descriptors in the forthcoming (seventh) edition of the TNM classification for lung cancer.J Thorac Oncol. 2007; 2: 593-602Crossref PubMed Scopus (553) Google Scholar However, revision of non–size-based T2 descriptors has not been recommended because of the small number of patients, inconsistent clinical and pathologic results, or lack of validation.5Rami-Porta R. Ball D. Crowley J. Giroux D.J. Jett J. Travis W.D. et al.The IASLC Lung Cancer Staging Project: proposals for the revision of the T descriptors in the forthcoming (seventh) edition of the TNM classification for lung cancer.J Thorac Oncol. 2007; 2: 593-602Crossref PubMed Scopus (553) Google Scholar Their proposal emphasized the prognostic value of tumor size in NSCLC. Shimizu and colleagues1Shimizu K. Yoshida J. Nagai K. Nishimura M. Ishii G. Morishita Y. et al.Visceral pleural invasion is an invasive and aggressive indicator of non-small cell lung cancer.J Thorac Cardiovasc Surg. 2005; 130: 160-165Abstract Full Text Full Text PDF PubMed Scopus (140) Google Scholar have also demonstrated that VPI was significantly associated with tumor size. We wonder how the authors dealt with the interaction of the 2 variables in multivariate analysis and interpreted the greater effect of VPI on survival in their study. Visceral pleural invasion is an invasive and aggressive indicator of non-small cell lung cancerThe Journal of Thoracic and Cardiovascular SurgeryVol. 130Issue 1PreviewAlthough visceral pleural invasion by non-small cell lung cancer is considered a poor-prognostic factor, further information is lacking, especially in relation to other clinicopathologic prognostic factors. We assessed the relationship between visceral pleural invasion and other clinicopathologic characteristics and evaluated its significance as a prognostic factor. Full-Text PDF" @default.
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• W2010317100 title "Prognostic significance of visceral pleural invasion and tumor size in non–small cell lung cancer" @default.
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