Patients with small peripheral non–small cell lung cancer (NSCLC) and visceral pleural invasion have worse disease-free and recurrence-free survival rates, as well as higher rates of recurrence, regardless of the extent of surgical resection. The impact of visceral pleural invasion on overall survival, however, is not significant. This was discovered through a secondary analysis of the CALGB 140503 clinical trial involving 697 patients with small NSCLC tumors. The presence of visceral pleural invasion was associated with high recurrence rates, suggesting the presence of micrometastatic disease at diagnosis. The study was published in JAMA Oncology and was supported by the National Cancer Institute.
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