Lymphovascular Invasion as the Major Prognostic Factor in Node-Negative Esophageal Cancer After Primary Esophagectomy

Hsu, Chiao Po; Chuang, Chun‐Yi; Hsu, Po Kuei; Chien, Li-Yin; Lin, Chih Hung; Yeh, Yi Chen; Hsu, Han Shui; Wu, Yu Chung

doi:10.1007/s11605-019-04310-0

Cited by 23 publications

(19 citation statements)

References 27 publications

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“…Previous studies have confirmed that neoadjuvant therapy can affect the evaluation of LVI after oesophagectomy [ 4 , 17 ], so we excluded all the specimens of these patients receiving neoadjuvant therapy. H&E staining of LVI sections was reviewed blinded to the pathological report and evaluated by the attending pathologists.…”

Section: Methodsmentioning

confidence: 99%

“…Although some studies have indicated an incidence reduction in the last few decades, oesophageal cancer is a significant public health burden in China [ 2 ]. Recently, the rate of superficial oesophageal squamous cell carcinoma has been increasing because of advances in endoscopic diagnosis and treatment; even so, the prognosis remains poor [ 3 , 4 ]. Several studies have evaluated risk factors for cancer recurrence and survival.…”

Section: Introductionmentioning

confidence: 99%

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The role of vascular invasion and lymphatic invasion in predicting recurrent thoracic oesophageal squamous cell carcinoma

Yao

et al. 2022

World J Surg Onc

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Background Numerous studies have addressed lymphovascular invasion (LVI) in patients with thoracic oesophageal squamous cell carcinoma (ESCC); however, little is known about the individual roles of lymphatic invasion (LI) and vascular invasion (VI). We aimed to analyse the prognostic significance of LI and VI in patients with thoracic ESCC from a single centre. Methods This retrospective study included 396 patients with thoracic ESCC who underwent oesophagectomy and lymphadenectomy in our hospital. The relationship between LI, VI and the other clinical features was analysed, and disease-free survival (DFS) was calculated. Survival analysis was performed by univariate and multivariate statistics. Results Briefly, VI and LI were present in 25.8% (102 of 396) and 23.7% (94 of 396) of ESCC patients, respectively, with 9.15% patients presenting both LI and VI; the remaining patients did not present LI or VI. We found that LI was significantly associated with pN stage (P<0.001) and pTNM stage (P<0.001), and similar results were found in VI. Moreover, survival analysis showed that pT stage (P<0.001), pN stage (P=0.001), pTNM stage (p<0.001), VI (P=0.001) and LI (P<0.001) were associated with DFS in ESCC. Furthermore, multivariate analysis suggested that pT stage (RR=1.4, P =0.032), pN stage (RR=1.9, P<0.001) and LI (RR=1.5, P=0.008) were independent predictive factors for DFS. Finally, relapse was observed in 110 patients (lymph node metastasis, 78 and distant, 32) and 147 patients with cancer-related deaths. Subanalysis showed that LI-positive patients had higher lymph node metastasis, although there was no significant difference (32.1% vs. 15.6%, P=0.100). Conclusions LI and VI were common in ESCC; they were all survival predictors for patients with ESCC, and LI was independent. Patients with positive LI were more likely to suffer lymph node metastasis.

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Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

The role of vascular invasion and lymphatic invasion in predicting recurrent thoracic oesophageal squamous cell carcinoma

Yao

et al. 2022

World J Surg Onc

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“…NCCN guidelines had also pointed out that patients with early stage esophageal or gastric cancer receiving endoscopic treatment, when pathological risk factors exist, more comprehensive systemic treatment and careful follow-up should be considered [10,11]. In terms of AEG, con icts still existed on whether the pathological adverse features would independently impact prognosis [12][13][14] like esophageal cancer or gastric cancer [15][16][17].…”

Section: Discussionmentioning

confidence: 99%

Prognostic Impact of Pathological Adverse Features in Surgically Resected Adenocarcinoma of Esophagogastric Junction

Liao¹,

Zheng²,

Xiong³

et al. 2021

Preprint

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Objective The prognostic value of lymphovascular invasion (LVI), perineural invasion (PNI), and poor differentiation (PD) has been widely studied in different solid tumors. However, it was still controversial in adenocarcinoma of esophagogastric junction (AEG). We investigated the prognostic impact of combining LVI, PNI and PD for predicting the survival in patients with AEG.Methods We retrospectively investigated the data of patients who performed surgical resection of AEG on Guangdong Provincial Hospital and Guangdong Provincial Hospital of Chinese Medicine from Jan. 2004 to Dec. 2018. According to the status of LVI, PNI and differentiation, pathological adverse features were divided into three groups: 0, 1 or 2 and 3 adverse features, their impact on prognosis was evaluated. Results Univariate analysis indicated pT, pN, LVI , PNI , PD and pathological adverse features were risk factors for both overall survival (OS) and disease-specific survival (DSS), and multivariate analysis indicated that pathological adverse feature was independent risk factor for both OS and DSS. In subgroup analyses, adverse features were independent risk factor for DSS of stage II AEG but not for stage I or III.Conclusions The pathological adverse features were independent prognostic factors for AEG patients and they can help for further risk stratification in stage II patients.

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“…11,29 According to previous studies, LVI is an independent risk factor for prognosis of esophageal and gastric cancer. 11,19,30 Similar to esophageal and gastric cancer, is LVI an independent risk factor for long-term survival of AEG? Burkhard et al 14 demonstrate the prognostic significance of LVI in patients with AEG tumors, with marked differences between the subgroups AEG I versus AEG II/ III.…”

Section: Discussionmentioning

confidence: 99%

“…It has been reported in a previous study that LVI were an independent risk factor for prognosis of some tumors. 11,18,19 However, whether the influence of LVI on AEG in long-term survival is still not be well answered and remained controversial. 14,20,21 There are few reports on whether LVI affect long-term survival in AEG.…”

Section: Introductionmentioning

confidence: 99%

<p>Lymphovascular Invasion as a Prognostic Factor in Non-Metastatic Adenocarcinoma of Esophagogastric Junction After Radical Surgery</p>

Zheng

Feng

Zheng

et al. 2020

CMAR

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Purpose Tumors with lymphovascular invasion (LVI) are thought to be associated with lymph node metastasis and to lead to a worse prognosis. However, the effect of LVI on the prognosis of adenocarcinoma of esophagogastric junction (AEG) is still unclear. Patients and Methods We retrospectively analyzed 224 consecutive patients with non-metastatic AEG who underwent radical surgery in our hospital from 2004 to 2018. Inverse probability weighting (IPW) analysis was used to eliminate the selection bias. IPW-adjusted Kaplan–Meier curves and Cox proportional hazards models were used to compare disease-specific survival (DSS) and overall survival (OS) between patients with and without LVI. Results A total of 224 patients with non-metastatic AEG who underwent radical resection were included in the study and 96 (42.9%) patients developed LVI. Survival analysis showed that LVI were associated with worse DSS (hazard ratio (HR) = 3.12; 95% CI: 1.93–5.03) and worse OS (HR = 2.33; 95% CI: 1.61–3.38). The results were consistent across subgroups stratified by pathologic N stage. Subgroup analysis demonstrated that Siewert type III (HR= 3.20, 95% CI: 1.45–7.06) was associated with worse DSS, but not Siewert type I/II (HR= 1.46, 95% CI: 0.94–2.31, P-interaction=0.047). Conclusion LVI are associated with worse prognosis in AEG. LVI had a worse effect on DSS in Siewert type III AEG than Siewert type I/II AEG.

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Lymphovascular Invasion as the Major Prognostic Factor in Node-Negative Esophageal Cancer After Primary Esophagectomy

Cited by 23 publications

References 27 publications

The role of vascular invasion and lymphatic invasion in predicting recurrent thoracic oesophageal squamous cell carcinoma

The role of vascular invasion and lymphatic invasion in predicting recurrent thoracic oesophageal squamous cell carcinoma

Prognostic Impact of Pathological Adverse Features in Surgically Resected Adenocarcinoma of Esophagogastric Junction

<p>Lymphovascular Invasion as a Prognostic Factor in Non-Metastatic Adenocarcinoma of Esophagogastric Junction After Radical Surgery</p>

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