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Christine M Hebert
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P08 - Early Stage/Localized Disease - Epidemiology (ID 117)
- Event: WCLC 2020
- Type: Posters
- Track: Early Stage/Localized Disease
- Presentations: 1
- Moderators:
- Coordinates: 1/28/2021, 00:00 - 00:00, ePoster Hall
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P08.06 - Factors Associated with the Diagnosis of Lymphatic Vascular Invasion and its Impact on Prognosis. (ID 3773)
00:00 - 00:00 | Presenting Author(s): Christine M Hebert
- Abstract
Introduction
The criteria for diagnosis of lymphatic vascular invasion have not been standardized. Our investigation uses the National Cancer Database(NCDB) to assess the impact of this factor on survival(OS) and determine factors associated with the diagnosis(LVI-D) of LVI and whether it is positive(LVI+).
Methods
The NCDB was queried from the years 2010-2016 to find a patient population who underwent (bi)lobectomy with at least ten lymph nodes examined. Multivariable analysis was used to find factors associated with LVI-D, LVI+, and the impact of LVI on OS. Propensity score matching(PSM) adjusting for factors associated with OS was used to determine the LVI’s OS impact by grade and Node stage(n-stage).
Results
32,793 patients were eligible for our study with a median follow-up of (41.1 months). LVI status was determined in 92%. LVI was significantly less likely to be diagnosed, but more likely to be positive with higher grade lesions, larger tumor sizes, and node involvement. 21% of surgical specimens were found to be LVI positive. 43.2% of specimens with positive nodes had LVI, while 12.9% of specimens with negative nodes had LVI.
Academic medical centers(AC); Medical centers with populations >1,000,000(1M); and the Mid-Atlantic(MA) region reported higher rates of LVI(all p values <0.0001, OR = 1.29; 1.21 and 1.61 respectively), and higher rates of LVI associated with positive nodes (all p values < 0.0001, OR = 1.22, 1.89; and 1.56, respectively).
LVI was associated with a significant decrement in OS that was independent of institution type, region population, and institution location. PSM demonstrated that LVI was associated with a decrement in OS to the same degree per each nodal stage(N0,N1,N2) (p<0.0003, HRs = 1.39 N0, 1.24 N1, 1.20 N2) and grade (well, moderately, Poorly differentiated) (p<0.0001, HRs = 1.97 WD, 1.65 MD, 1.47 PD).
Conclusion
LVI was less likely to be diagosed, but LVI positivity was more likely in tumors with adverse features(larger tumor sizes, positive nodes, and higher grade). LVI+ was associated with positive nodes and varied based upon hospital location/type and population. LVI was associated with a decrement in OS that was independent of n-stage and grade. LVI must be standardized and considered as a prognostic factor for staging cancer patients.
