18008 Background: Angiogenesis is accepted as being essential for tumors to grow and metastasize to distant sites. Lymphatic metastasis is also an important means of tumor spread. Vascular endothelial growth factor C (VEGF-C) plays and important role in lymphangiogenesis and activates VEGFR (VEGF receptor)-3. Numerous studies suggest that tumor expression of VEGF-C is a significant prognostic factor in NSCLC. In non-small cell lung carcinoma (NSCLC), the relationship of lymphangiogenesis with lymph node metastasis and patient prognosis is unknown. Methods: A retrospective analysis of 78 patients who were diagnosed with NSCLC from 1987 to 2004 were analyzed for lymphatic vascular density (LVD). LVD was measured by use of D2–40 monoclonal antibody staining. Survival was assessed and Mantel-Cox and Wilcoxon signed rank tests were used for statistical analysis. Results: Intratumoral and peritumoral LVD was significantly higher than in the uninvolved adjacent lung, but showed no significant association with lymph node status at the time of tumor resection. Variables which appeared to affect survival in our study were the presence of lymph node metastasis (median survival 1,425 vs absence 467 days, p=0.002). The presence of VEGF staining inversely affected median survival (present 757 vs absent 1,944 days, p= 0.014). LVD ≤ 53 events per field 895 days vs >53 median survival 1,302 days, p+0.867. Survival appeared to not be affected by LVD. Conclusions: These data suggest that although lymphangiogenesis occurs in association with NSCLC, it may not be an important factor in lymph node metastasis or in survival. In fact, there is a suggestion that the number of lymphatics that a patient inherently has appears to be more important than lymphangiogenesis when it comes to the development of lymph node metastasis. No significant financial relationships to disclose.
The Significance of Skip Mediastinal Lymph Node Metastasis in the Prognosis of Patients with Resected Non-Small-Cell Lung Carcinoma: Is It Really a Better N2 Disease Subtype?
