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Prognostic impact of vascular invasion and standardization of its evaluation in stage I non-small cell lung cancer

Overview of attention for article published in Diagnostic Pathology, April 2015
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Title
Prognostic impact of vascular invasion and standardization of its evaluation in stage I non-small cell lung cancer
Published in
Diagnostic Pathology, April 2015
DOI 10.1186/s13000-015-0249-5
Pubmed ID
Authors

Rurika Hamanaka, Tomoyuki Yokose, Yuji Sakuma, Masahiro Tsuboi, Hiroyuki Ito, Haruhiko Nakayama, Kouzo Yamada, Ryota Masuda, Masayuki Iwazaki

Abstract

Patients with pathologic stage (p-Stage) IA non-small cell lung cancer (NSCLC) have a good survival rate because of possible curative resection. However, up to 10% of these patients relapse postoperatively. To identify unfavorable prognostic factors, we retrospectively analyzed the clinicopathological features of p-Stage IA disease, focusing on vascular invasion. Of 467 patients with p-Stage I NSCLC, 335 were diagnosed with p-Stage IA or IB disease based on a lesion size ≤3 cm and the presence of pleural invasion (PL). Univariate and multivariate analyses of recurrence-free survival (RFS) were performed with age, sex, PL, and vascular invasion (blood vessel invasion [v] and lymphatic vessel invasion [ly]) as variables. To examine vascular invasion, hematoxylin-eosin (HE), Elastica van Gieson staining, and immunostaining with anti-podoplanin antibody were performed. The presence or absence of v and ly was recorded; the number of involved vessels was counted. Survival rates were obtained using the Kaplan-Meier method and log-rank test. Multivariate analyses were performed using the Cox proportional hazards model. RFS differed significantly between patients with no or one involved blood vessel (0 v or 1 v) and those with ≥2 involved vessels (≥2 v). Similarly, RFS differed significantly between patients with no lymphatic vessel involvement (0 ly) and those with one involved lymphatic vessel (1 ly). Thus, BVI(+) and BVI(-) were defined as ≥2 v and 0 v + 1 v, and LVI(+) and LVI(-) as ≥1 ly and 0 ly, respectively. BVI and LVI together represented tumor vessel invasion (TVI). On multivariate analyses, PL and TVI were independently associated with recurrence. Additionally, patients with p-Stage IA TVI(+) disease had a comparable recurrence rate to those with p-Stage IB disease. Similar to PL, TVI is an important factor increasing the likelihood of recurrence. As HE staining alone is insufficient for evaluating vascular invasion, specific staining is necessary. Moreover, patients with p-Stage IA TVI(+) disease had a recurrence rate comparable to those with p-Stage IB disease; therefore, further studies should aim to elucidate whether patients with p-Stage IA TVI(+) disease should be administered postoperative chemotherapy similar to that received by p-Stage IB patients. The virtual slide(s) for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/5213064891369688.

Twitter Demographics

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Mendeley readers

The data shown below were compiled from readership statistics for 17 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
United States 1 6%
Unknown 16 94%

Demographic breakdown

Readers by professional status Count As %
Researcher 4 24%
Other 3 18%
Student > Ph. D. Student 3 18%
Student > Postgraduate 3 18%
Professor > Associate Professor 2 12%
Other 0 0%
Unknown 2 12%
Readers by discipline Count As %
Medicine and Dentistry 10 59%
Agricultural and Biological Sciences 1 6%
Computer Science 1 6%
Social Sciences 1 6%
Pharmacology, Toxicology and Pharmaceutical Science 1 6%
Other 0 0%
Unknown 3 18%

Attention Score in Context

This research output has an Altmetric Attention Score of 1. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 03 April 2015.
All research outputs
#6,637,616
of 8,713,920 outputs
Outputs from Diagnostic Pathology
#444
of 701 outputs
Outputs of similar age
#143,512
of 202,313 outputs
Outputs of similar age from Diagnostic Pathology
#33
of 41 outputs
Altmetric has tracked 8,713,920 research outputs across all sources so far. This one is in the 13th percentile – i.e., 13% of other outputs scored the same or lower than it.
So far Altmetric has tracked 701 research outputs from this source. They receive a mean Attention Score of 2.2. This one is in the 20th percentile – i.e., 20% of its peers scored the same or lower than it.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 202,313 tracked outputs that were published within six weeks on either side of this one in any source. This one is in the 15th percentile – i.e., 15% of its contemporaries scored the same or lower than it.
We're also able to compare this research output to 41 others from the same source and published within six weeks on either side of this one. This one is in the 9th percentile – i.e., 9% of its contemporaries scored the same or lower than it.