Prognostic Value of Lymphovascular Invasion in Node-Negative Upper Urinary Tract Urothelial Carcinoma Patients Undergoing Radical Nephroureterectomy
10.3349/ymj.2019.60.2.174
- Author:
Wen LIU
1
;
Zhonghan ZHOU
;
Dahai DONG
;
Lijiang SUN
;
Guiming ZHANG
Author Information
1. Department of Urology, The Affiliated Hospital of Qingdao University, Qingdao, China. zhangguiming9@126.com
- Publication Type:Original Article
- Keywords:
Urinary tract;
prognosis;
neoplasm invasiveness;
carcinoma, transitional cell;
lymph nodes
- MeSH:
Carcinoma, Transitional Cell;
Chemotherapy, Adjuvant;
Humans;
Lymph Nodes;
Methods;
Multivariate Analysis;
Necrosis;
Neoplasm Invasiveness;
Neoplasm Metastasis;
Prognosis;
Urinary Tract
- From:Yonsei Medical Journal
2019;60(2):174-181
- CountryRepublic of Korea
- Language:English
-
Abstract:
PURPOSE: This study aimed to evaluate the prognostic impact of lymphovascular invasion (LVI) in patients treated with radical nephroureterectomy (RNU) for upper urinary tract urothelial carcinoma (UTUC). MATERIALS AND METHODS: We collected data from 180 patients who were treated with RNU from 2005 to 2013 at our institution. The Kaplan-Meier method with log-rank test and Cox proportional hazards regression models were used for univariate and multivariate analyses. RESULTS: LVI was present in 28 patients (15.6%), which was associated with higher pathological tumor stage (p < 0.001), tumor necrosis (p=0.012), lymph node metastasis (p=0.017) and multifocality (p=0.012). On multivariate analysis, LVI was an independent prognostic factor of recurrence-free survival [RFS: hazard ratio (HR)=2.954; 95% confidence interval (CI)=1.539–5.671; p=0.001] and cancer-specific survival (CSS: HR=3.530; 95% CI=1.701–7.325; p=0.001) in all patients. In patients with node-negative UTUC, LVI was also a significant predictor of RFS (HR=3.732; 95% CI 1.866–7.464; p < 0.001) and CSS (HR=3.825; 95% CI=1.777–8.234; p=0.001). CONCLUSION: LVI status was an independent predictor in patients with UTUC who underwent RNU. The estimate of LVI could help physicians identify high-risk patients and make a better medication regimen of adjuvant chemotherapy.
