Lymphovascular Invasion as a Prognostic Indicator in Stage I Non-Small Cell Lung Cancer: A Systematic Review and Meta-Analysis

Mollberg, Nathan M.; Bennette, Carrie; Howell, Eric; Backhus, Leah M.; Devine, Beth; Ferguson, Mark K.

doi:10.1016/j.athoracsur.2013.11.002

Cited by 75 publications

(37 citation statements)

References 34 publications

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“…Definitions of LVI vary from author to author, and there are issues of overdetection with artifacts, all of which contribute to the confusion regarding this particular pathologic finding [6]. In other malignancies, such as thyroid [7], lung [8], stomach [9], bladder [10], kidney [11], and breast cancers [12], LVI is considered as an independent prognostic factor. Regarding the prostate, despite the unclear prognostic value of LVI in prior studies conducted in the general population, more recent investigations of patients in particular stages show some promising aspects [1, 13, 14].…”

Section: Introductionmentioning

confidence: 99%

Impact of lymphovascular invasion on lymph node metastasis for patients undergoing radical prostatectomy with negative resection margin

et al. 2017

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BackgroundThe association between lymphovascular invasion and lymphatic or hematogenous metastasis has been suspected, with conflicting evidence. We have investigated the association between the risk of biochemical recurrence and lymphovascular invasion in resection margin negative patients, as well as its association with lymph node metastasis.MethodsOne thousand six hundred thirty four patients who underwent radical prostatectomy from 2005 to 2014 were selected. Patients with bone or distant organ metastasis at the time of operation were excluded. Survival analysis was performed to assess biochemical recurrence, metastasis and mortality risks by Kaplan-Meier analysis and multivariate Cox proportional hazard regression. Odds of lymph node metastasis were evaluated by Logistic regression.ResultsLVI was detected in 118 (7.4%) patients. The median follow-up duration was 33.1 months. In the Kaplan-Meier analysis, lymphovascular invasion was associated with significantly increased 5-year and 10-year BCR rate (60.2% vs. 39.1%, 60.2% vs. 40.1%, respectively; p < 0.001), 10-year bone metastasis rate and cancer specific mortality (16.9% vs. 5.1%, p = 0.001; 6.8% vs. 2.7%, p = 0.034, respectively) compared to patients without LVI. When stratified by T stage and resection margin status, lymphovascular invasion resulted in significantly increased 10-year biochemical recurrence rate in T3 patients both with and without positive surgical margin (p = 0.008, 0.005, respectively). In the multivariate Cox regression model lymphovascular invasion resulted in 1.4-fold BCR risk and 1.7-fold metastasis risk increase (95% CI 1.045–1.749, 1.024–2.950; p = 0.022, 0.040, respectively). Lymphovascular invasion was revealed to be strongly associated with lymph node metastasis in the multivariate Logistic regression (OR 4.317, 95% CI 2.092–8.910, p < 0.001).ConclusionLymphovascular invasion increases the risk of recurrence in T3 patients regardless of margin status, by accelerating lymph node metastasis and distant organ metastasis.Electronic supplementary materialThe online version of this article (doi:10.1186/s12885-017-3307-4) contains supplementary material, which is available to authorized users.

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Section: Introductionmentioning

confidence: 99%

Impact of lymphovascular invasion on lymph node metastasis for patients undergoing radical prostatectomy with negative resection margin

et al. 2017

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“…Visceral pleural invasion is a well‐established adverse prognostic factor for early‐stage NSCLC . Many studies reported that lymphatic invasion or lymphovascular invasion is also a poor prognostic factor in early‐stage NSCLC . However, lymphatic invasion has not been adopted as a descriptor in the TNM classification system.…”

Section: Introductionmentioning

confidence: 99%

Lymphatic invasion is a more significant prognostic factor than visceral pleural invasion in non‐small cell lung cancer with tumours of 3 cm or less

et al. 2017

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“…Tumor cells first infiltrate into lymphatic and/or vascular vessels, and then disseminate,3839 which is a much more common phenomenon in malignant tumors including PCA 40. In addition, LVI is a significant prognostic factor in bladder, upper urinary tract urothelial and lung cancers, which has been confirmed in several systematic review studies 414243. As regards to liver and testicular tumors, LVI has been added to the TNM staging system, in terms of improved tumor staging 4445.…”

Section: Discussionmentioning

confidence: 95%

The prognostic value of lymphovascular invasion in radical prostatectomy: a systematic review and meta-analysis

Huang

Pan

et al. 2016

Asian J Androl

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To systematically evaluate the prognostic value of lymphovascular invasion (LVI) in radical prostatectomy (RP) by a meta-analysis based on the published literature. To identify relevant studies, PubMed, Cochrane Library, and Web of Science database were searched from 1966 to May 2014. Finally, 25 studies (9503 patients) were included. LVI was found in 12.2% (1156/9503) of the RP specimens. LVI was found to be correlated with higher pathological tumor stages (greater than pT3 stage) (risk ratio [RR] 1.90, 95% confidence interval [CI] 1.73–2.08, P < 0.00001), higher Gleason scores (greater than GS = 7) (RR 1.30, 95% CI 1.23–1.38, P < 0.00001), positive pathological node (pN) status (RR 5.67, 95% CI 3.14–10.24, P < 0.00001), extracapsular extension (RR 1.72, 95% CI 1.46–2.02, P < 0.00001), and seminal vesicle involvement (RR 3.36, 95% CI 2.41–4.70, P < 0.00001). The pooled hazard ratio (HR) was statistically significant for Biochemical Recurrence-Free (BCR-free) probability (HR 2.05, 95% CI 1.64–2.56; Z = 6.30, P < 0.00001). Sensitivity analysis showed that the pooled HR and 95% CI were not significantly altered by the omission of any single study. Begg's Funnel plots showed no significant publication bias (P = 0.112). In conclusion, LVI exhibited a detrimental effect on the BCR-Free probability and clinicopathological features in RP specimens, and may prove to be an independent prognostic factor of BCR.

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Lymphovascular Invasion as a Prognostic Indicator in Stage I Non-Small Cell Lung Cancer: A Systematic Review and Meta-Analysis

Cited by 75 publications

References 34 publications

Impact of lymphovascular invasion on lymph node metastasis for patients undergoing radical prostatectomy with negative resection margin

Impact of lymphovascular invasion on lymph node metastasis for patients undergoing radical prostatectomy with negative resection margin

Lymphatic invasion is a more significant prognostic factor than visceral pleural invasion in non‐small cell lung cancer with tumours of 3 cm or less

The prognostic value of lymphovascular invasion in radical prostatectomy: a systematic review and meta-analysis

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