Lymphovascular invasion in radical cystectomy specimen: Is it an independent prognostic factor in patients without lymph node metastases?

Murugesan Manoharan, Devendar Katkoori, T. A. Kishore, Merce Jorda, Tony Luongo, Mark S. Soloway

Research output: Contribution to journalArticle

18 Citations (Scopus)

Abstract

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.

Original languageEnglish
Pages (from-to)233-237
Number of pages5
JournalWorld Journal of Urology
Volume28
Issue number2
DOIs
StatePublished - Jan 1 2010

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Cystectomy
Lymph Nodes
Neoplasm Metastasis
Survival
Lymph Node Excision
Recurrence
Multivariate Analysis
Histology
Urinary Bladder
Endothelial Cells
Databases
Carcinoma
Drug Therapy
Neoplasms

Keywords

  • Bladder cancer
  • Lymph node negative
  • Lymphovascular invasion
  • Prognosis
  • Radical cystectomy

ASJC Scopus subject areas

  • Urology

Cite this

Lymphovascular invasion in radical cystectomy specimen : Is it an independent prognostic factor in patients without lymph node metastases? / Manoharan, Murugesan; Katkoori, Devendar; Kishore, T. A.; Jorda, Merce; Luongo, Tony; Soloway, Mark S.

In: World Journal of Urology, Vol. 28, No. 2, 01.01.2010, p. 233-237.

Research output: Contribution to journalArticle

Manoharan, Murugesan ; Katkoori, Devendar ; Kishore, T. A. ; Jorda, Merce ; Luongo, Tony ; Soloway, Mark S. / Lymphovascular invasion in radical cystectomy specimen : Is it an independent prognostic factor in patients without lymph node metastases?. In: World Journal of Urology. 2010 ; Vol. 28, No. 2. pp. 233-237.
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abstract = "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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T1 - Lymphovascular invasion in radical cystectomy specimen

T2 - Is it an independent prognostic factor in patients without lymph node metastases?

AU - Manoharan, Murugesan

AU - Katkoori, Devendar

AU - Kishore, T. A.

AU - Jorda, Merce

AU - Luongo, Tony

AU - Soloway, Mark S.

PY - 2010/1/1

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N2 - 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.

AB - 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.

KW - Bladder cancer

KW - Lymph node negative

KW - Lymphovascular invasion

KW - Prognosis

KW - Radical cystectomy

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