In patients undergoing RC, removal of a higher LN count is associated with an improved oncological outcome. The information resulting from an assessment of lymphovascular invasion and an extended lymphadenectomy is critical for stratification of risk groups and identification of patients who might benefit from adjuvant treatment.

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cells within an unequivocal endotheliumlined space in haematoxylin and eosinstained sections. RESULTSLVI was present in 295 (26.8%) patients; the presence of LVI correlated significantly with increasing tumour stage, i.e. pT1, 65 (29.4%); pT2, 88 (31.5%); pT3 110 (31.8%); and pT4 32 (38.1%) ( P = 0.002) and grade ( P < 0.001). In univariable analysis the presence of LVI was significantly associated with reduced recurrence-free survival ( P = 0.008) and reduced CSS ( P = 0.039). On multivariable Cox regression analysis tumour stage ( P < 0.001), age ( > 75 vs ≥ 75 years; P = 0.018) and LVI ( P < 0.001) were identified as independent predictors of CSS. CONCLUSIONSOur large multicentre study confirms the independent prognostic value of LVI in patients with node-negative UBC. LVI can be regarded as a surrogate variable for lymphatic micrometastasis in node-negative UBC. Assessment of LVI might improve the selection of patients who are likely to benefit from adjuvant therapy after RC. The identification of factors involved in the process of LVI could reveal new therapeutic targets for UBC.