Lymphovascular invasion predicts poor prognosis in high-grade pT1 bladder cancer patients who underwent transurethral resection in one piece

Ukai, Rinzo; Hashimoto, Kazuhito; Nakayama, Hirofumi; Iwamoto, Toshiyuki

doi:10.1093/jjco/hyx012

Cited by 17 publications

(17 citation statements)

References 23 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…LVI definition was provided in 16 studies (48.5%) and was found in 1 069 of 6194 patients (17.3%). Pathological characteristics are reported in Table . Overall, 62% of patients had NMIBC, 32% had cT2 stage and 6% had cT3–4 stage.…”

Section: Evidence Synthesismentioning

confidence: 99%

“…The results from a previous meta-analysis suggested an increased risk of pathological upstaging and poor clinical outcomes in patients with LVI at TURBT [9]; however, the selection criteria included all studies regardless of the patients' tumour stage. Moreover, new studies have added further data with which to analyse the prognostic impact of LVI at TUR in patients with organ-confined BCa [10][11][12][13][14][15][16][17][18].…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

A systematic review and meta‐analysis of the impact of lymphovascular invasion in bladder cancer transurethral resection specimens

et al. 2018

View full text Add to dashboard Cite

The aim of the present review was to assess the prognostic impact of lymphovascular invasion (LVI) in transurethral resection (TUR) of bladder cancer (BCa) specimens on clinical outcomes. A systematic review and meta-analysis of the available literature from the past 10 years was performed using MEDLINE, EMBASE and Cochrane library in August 2017. The protocol for this systematic review was registered on PROSPERO (Central Registration Depository: CRD42018084876) and is available in full on the University of York website. Overall, 33 studies (including 6 194 patients) evaluating the presence of LVI at TUR were retrieved. LVI was detected in 17.3% of TUR specimens. In 19 studies, including 2 941 patients with ≤cT1 stage only, LVI was detected in 15% of specimens. In patients with ≤cT1 stage, LVI at TUR of the bladder tumour (TURBT) was a significant prognostic factor for disease recurrence (pooled hazard ratio [HR] 1.97, 95% CI: 1.47-2.62) and progression (pooled HR 2.95, 95% CI: 2.11-4.13), without heterogeneity (I = 0.0%, P = 0.84 and I = 0.0%, P = 0.93, respectively). For patients with cT1-2 disease, LVI was significantly associated with upstaging at time of radical cystectomy (pooled odds ratio 2.39, 95% CI: 1.45-3.96), with heterogeneity among studies (I = 53.6%, P = 0.044). LVI at TURBT is a robust prognostic factor of disease recurrence and progression in non-muscle invasive BCa. Furthermore, LVI has a strong impact on upstaging in patients with organ-confined disease. The assessment of LVI should be standardized, reported, and considered for inclusion in the TNM classification system, helping clinicians in decision-making and patient counselling.

show abstract

Section: Evidence Synthesismentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

A systematic review and meta‐analysis of the impact of lymphovascular invasion in bladder cancer transurethral resection specimens

et al. 2018

View full text Add to dashboard Cite

show abstract

“…Lymphovascular invasion (LVI), which is defined as the presence of tumor cells within lymphatic or vascular channels, is a significant step in tumor distant metastasis (5,6). According to the recommended European urology guidelines, LVI is an independent prognostic factor for bladder cancer using cystectomy specimens (7).…”

Section: Introductionmentioning

confidence: 99%

The Prognostic Value of Lymphovascular Invasion in Patients With Upper Tract Urinary Carcinoma After Surgery: An Updated Systematic Review and Meta-Analysis

Zhang

Zha

et al. 2020

Front. Oncol.

View full text Add to dashboard Cite

Background and Purpose: Although the prognostic value of lymphovascular invasion (LVI) for upper tract urinary carcinoma (UTUC) has been reported, there is a lack of consensus regarding the prognostic factor of LVI in UTUC after radical nephroureterectomy (RNU). The aim of the present study was to evaluate the contemporary role of LVI using systematic review and meta-analysis.Materials and Methods: Using Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines, we performed a systematic search of Web of Science, PubMed, and EMBASE for all reports published up to July 2019. Cumulative analyses of hazard ratios (HRs)/odds ratios (ORs) and their corresponding 95% confidence intervals were conducted to assess the association between LVI and oncological outcomes and clinicopathological features.Results: Our meta-analysis included 31 eligible studies containing 14,653 patients with UTUC (81-1,363 per study). Our results indicated a significant correlation of LVI with worse cancer-specific survival (HR = 1.59, p < 0.001), overall survival (HR = 1.55, p < 0.001), recurrence-free survival (HR = 1.46, p < 0.001), cancer-specific mortality (HR = 1.25, p = 0.047), and recurrence (HR = 1.23, p = 0.026). LVI was also correlated with advanced tumor stage (III/IV vs. I/II: OR = 7.63, p < 0.001), higher tumor grade (3 vs. 1/2: OR = 5.61, p < 0.001), lymph node metastasis (yes vs. no: OR = 4.95, p < 0.001), carcinoma in situ (yes vs. no: OR = 1.92, p < 0.001), and positive surgical margin (yes vs. no: OR = 4.38, p < 0.001), but not related to gender (male vs. female: OR = 0.98, p = 0.825), and multifocality (multifocal vs. unifocal: OR = 1.09, p = 0.555). The funnel plot test indicated no significant publication bias.Conclusions: This study demonstrated that LVI was associated with aggressive clinicopathological features. LVI may serve as a poor prognostic factor for patients with UTUC after RNU.

show abstract

“…The presence of lymphovascular invasion (LVI) has been suggested to predict poor prognosis of bladder cancer, such as more advanced disease and recurrence, and has been reported as a poor prognostic factor even for other carcinomas [1][2][3][4][5][6][7][8][9][10]. As transurethral resection of bladder tumor (TURBT) is a standard treatment for bladder cancer, the utility of identifying LVI in specimens of TURBT has been suggested [1][2][3][4][5][6][7][9][10][11][12][13]. The presence of LVI in TURBT specimens has been associated with pathologic upstaging and reduced recurrence-free survival (RFS) and progression-free survival [11].…”

Section: Introductionmentioning

confidence: 99%

Impact of lymphovascular invasion in bladder cancer ~Comparison of transurethral resection and total cystectomy: a retrospective cohort study

Yoneda

Utsumi

Wakai

et al. 2020

Preprint

View full text Add to dashboard Cite

Background: This study aimed to evaluate the associations of lymphovascular invasion (LVI) at first transurethral resection of bladder (TURBT) and radical cystectomy (RC) with survival outcomes, and to evaluate the concordance between LVI at first TURBT and RC. Methods: We reviewed 216 patients who underwent first TURBT and 64 patients who underwent RC at our hospital. Medical records were reviewed uniformly, collecting the following data: age, sex, clinical and pathological T stage, neoadjuvant chemotherapy, grade, metastasis, urinary cytology, carcinoma in situ and LVI. Results: LVI was identified in 22.7% of patients who underwent first TURBT, and 32.8% of patients who underwent RC. Univariate analysis identified ≥cT3, metastasis and LVI at first TURBT as factors significantly associated with overall survival (OS) and cancer-specific survival (CSS). Multivariate analysis identified metastasis (hazard ratio (HR) 6.560, p=0.009) and LVI at first TURBT (HR 9.205, p=0.003) as significant predictors of CSS. On the other hand, in patients who underwent RC, ≥pT3, inclusion of G3 and LVI were significantly associated with OS and CSS in univariate analysis. Multivariate analysis identified inclusion of G3 as a significant predictor of OS and CSS. The concordance rate between LVI at first TURBT and RC was 48.0%. Patients with positive results for LVI at first TURBT and RC displayed poorer prognosis than other patients (p<0.05). Conclusions: We found that the combination of LVI at first TURBT and RC was likely to provide a more significant prognostic factor.

show abstract

Lymphovascular invasion predicts poor prognosis in high-grade pT1 bladder cancer patients who underwent transurethral resection in one piece

Abstract: The presence of LVI in TURBO specimens independently predicts poor clinical outcomes in patients with high-grade pT1 bladder cancer. This information may help urologists to counsel their patients when deciding whether to choose a bladder-preserving strategy or radical cystectomy.

Cited by 17 publications

References 23 publications

A systematic review and meta‐analysis of the impact of lymphovascular invasion in bladder cancer transurethral resection specimens

A systematic review and meta‐analysis of the impact of lymphovascular invasion in bladder cancer transurethral resection specimens

The Prognostic Value of Lymphovascular Invasion in Patients With Upper Tract Urinary Carcinoma After Surgery: An Updated Systematic Review and Meta-Analysis

Impact of lymphovascular invasion in bladder cancer ~Comparison of transurethral resection and total cystectomy: a retrospective cohort study

Contact Info

Product

Resources

About