OBJECTIVES: To assess the prognostic significance of lymphovascular invasion (LVI) on clinical outcomes in patients with transitional cell carcinoma of the bladder treated with radical cystectomy (RC). PATIENTS AND METHODS: We retrospectively evaluated a prospectively maintained and authorised cystectomy database; the presence or absence of LVI was determined by pathological examination of the RC specimen. Cox regression analysis and Kaplan-Meier tables were developed to evaluate the contribution of LVI to clinical outcomes. RESULTS: In all, we analysed 356 patients treated with RC and urinary diversion between 1988 and 2006, with a mean follow-up of 45.6 months. Of these patients, 242 (68%) had no evidence of LVI in the RC specimen, whereas 114 (32%) had LVI. Patients with LVI tended to present with higher pathological stage; 84 (74%) had pT3 or pT4 disease. On univariable analysis the presence of LVI conferred a significant risk for decreased overall, cancer-specific and recurrence-free survival (P < 0.001); the mean values for LVI-negative patients were 96.8, 157.4, and 135.0 months, respectively, vs LVI-positive patients, whose survival times were 52.3, 82.7 and 75.2 months, respectively. The multivariable analysis showed significant independent risk for cancer-specific and overall survival for patients who were LVI-positive and had no lymph-node metastases. The hazard ratios (95% confidence interval) were 1.63 (1.06-2.51, P < 0.026) and 1.81 (1.06-3.08, P < 0.03) for overall and disease-specific survival, respectively. CONCLUSIONS: The presence of LVI in the pathological RC specimen confers significant independent risk for reduced bladder cancer-specific and overall survival. This variable could be used to prospectively stratify patients who would benefit from adjuvant chemotherapy.
OBJECTIVES: To assess the prognostic significance of lymphovascular invasion (LVI) on clinical outcomes in patients with transitional cell carcinoma of the bladder treated with radical cystectomy (RC). PATIENTS AND METHODS: We retrospectively evaluated a prospectively maintained and authorised cystectomy database; the presence or absence of LVI was determined by pathological examination of the RC specimen. Cox regression analysis and Kaplan-Meier tables were developed to evaluate the contribution of LVI to clinical outcomes. RESULTS: In all, we analysed 356 patients treated with RC and urinary diversion between 1988 and 2006, with a mean follow-up of 45.6 months. Of these patients, 242 (68%) had no evidence of LVI in the RC specimen, whereas 114 (32%) had LVI. Patients with LVI tended to present with higher pathological stage; 84 (74%) had pT3 or pT4 disease. On univariable analysis the presence of LVI conferred a significant risk for decreased overall, cancer-specific and recurrence-free survival (P < 0.001); the mean values for LVI-negative patients were 96.8, 157.4, and 135.0 months, respectively, vs LVI-positive patients, whose survival times were 52.3, 82.7 and 75.2 months, respectively. The multivariable analysis showed significant independent risk for cancer-specific and overall survival for patients who were LVI-positive and had no lymph-node metastases. The hazard ratios (95% confidence interval) were 1.63 (1.06-2.51, P < 0.026) and 1.81 (1.06-3.08, P < 0.03) for overall and disease-specific survival, respectively. CONCLUSIONS: The presence of LVI in the pathological RC specimen confers significant independent risk for reduced bladder cancer-specific and overall survival. This variable could be used to prospectively stratify patients who would benefit from adjuvant chemotherapy.
Authors: Murugesan Manoharan; Devendar Katkoori; T A Kishore; Merce Jorda; Tony Luongo; Mark S Soloway Journal: World J Urol Date: 2009-07-12 Impact factor: 4.226
Authors: Stephen H Culp; Rian J Dickstein; H Barton Grossman; Shanna M Pretzsch; Sima Porten; Siamak Daneshmand; Jie Cai; Susan Groshen; Arlene Siefker-Radtke; Randall E Millikan; Bogdan Czerniak; Neema Navai; Matthew F Wszolek; Ashish M Kamat; Colin P N Dinney Journal: J Urol Date: 2013-07-30 Impact factor: 7.450