PURPOSE: To determine the prognostic significance of lymphovascular invasion (LVI) in patients with urothelial carcinoma of the bladder undergoing radical cystectomy (RC) and bilateral pelvic lymph node dissection. METHODS: From 1992 to 2008, 526 patients underwent RC and pelvic lymphadenectomy at our institution by a single surgical team. All relevant data were entered into a database and analyzed. LVI was defined as "the presence of tumor cells within an endothelial lined space." The exclusion criteria were non-TCC histology, salvage cystectomy, neoadjuvant chemotherapy, and unknown LVI status. RESULTS: A total of 357 patients met the inclusion criteria. Overall prevalence of LVI was 29%. LVI was significantly associated with higher T stage, lymph node (LN) metastases, and higher grade. Patients with LVI had significantly higher recurrence rate (P < 0.001) and decreased long-term survival (P < 0.001). In patients without LN metastases, LVI in the primary led to a significantly decreased recurrence-free (P = 0.003) and disease-specific survival (P = 0.001). In the presence of LN metastases, LVI did not significantly alter the recurrence-free or disease-specific survival. On multivariate analysis, T stage (P < 0.0001) and LN metastases (P = 0.01) were significant independent prognostic factors influencing disease-specific survival. LVI did not have independent prognostic value. T stage was the only significant prognostic factor in the lymph node negative group. CONCLUSIONS: Although, the presence of LVI in node-negative patients is an adverse prognostic factor on univariate analysis of disease-specific survival, it is not an independent prognostic factor on multivariate analysis. Pathological stage is the only independent prognostic factor for survival.
PURPOSE: To determine the prognostic significance of lymphovascular invasion (LVI) in patients with urothelial carcinoma of the bladder undergoing radical cystectomy (RC) and bilateral pelvic lymph node dissection. METHODS: From 1992 to 2008, 526 patients underwent RC and pelvic lymphadenectomy at our institution by a single surgical team. All relevant data were entered into a database and analyzed. LVI was defined as "the presence of tumor cells within an endothelial lined space." The exclusion criteria were non-TCC histology, salvage cystectomy, neoadjuvant chemotherapy, and unknown LVI status. RESULTS: A total of 357 patients met the inclusion criteria. Overall prevalence of LVI was 29%. LVI was significantly associated with higher T stage, lymph node (LN) metastases, and higher grade. Patients with LVI had significantly higher recurrence rate (P < 0.001) and decreased long-term survival (P < 0.001). In patients without LN metastases, LVI in the primary led to a significantly decreased recurrence-free (P = 0.003) and disease-specific survival (P = 0.001). In the presence of LN metastases, LVI did not significantly alter the recurrence-free or disease-specific survival. On multivariate analysis, T stage (P < 0.0001) and LN metastases (P = 0.01) were significant independent prognostic factors influencing disease-specific survival. LVI did not have independent prognostic value. T stage was the only significant prognostic factor in the lymph node negative group. CONCLUSIONS: Although, the presence of LVI in node-negative patients is an adverse prognostic factor on univariate analysis of disease-specific survival, it is not an independent prognostic factor on multivariate analysis. Pathological stage is the only independent prognostic factor for survival.
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Authors: Maximilian Burger; Shahrokh F Shariat; Hans-Martin Fritsche; Juan Ignacio Martinez-Salamanca; Kazumasa Matsumoto; Thomas F Chromecki; Vincenzo Ficarra; Wassim Kassouf; Christian Seitz; Armin Pycha; Stefan Tritschler; Thomas J Walton; Giacomo Novara Journal: World J Urol Date: 2011-06-01 Impact factor: 4.226
Authors: Matthias May; Christian Stief; Sabine Brookman-May; Wolfgang Otto; Christian Gilfrich; Jan Roigas; Mario Zacharias; Wolf F Wieland; Hans-Martin Fritsche; Ferdinand Hofstädter; Maximilian Burger Journal: World J Urol Date: 2011-10-09 Impact factor: 4.226