Prognostic Significance of Lymphovascular Invasion in Radical Cystectomy on Patients with Bladder Cancer: A Systematic Review and Meta-Analysis

Abstract

PurposeThe objective of the present study was to conduct a systematic review and meta-analysis of published literature to appraise the prognostic value of lymphovascular invasion (LVI) in radical cystectomy specimens.Materials and MethodsFollowing the PRISMA statement, PubMed, Cochrane Library, and SCOPUS database were searched from the respective dates of inception until June 2013.ResultsA total of 21 articles met the eligibility criteria for this systematic review, which included a total of 12,527 patients ranging from 57 to 4,257 per study. LVI was detected in 34.6% in radical cystectomy specimens. LVI was associated with higher pathological T stage and tumor grade, as well as lymph node metastasis. The pooled hazard ratio (HR) was statistically significant for recurrence-free survival (pooled HR, 1.61; 95% confidence interval [CI], 1.26–2.06), cancer-specific survival (pooled HR, 1.67; 95% CI, 1.38–2.01), and overall survival (pooled HR, 1.67; 95% CI, 1.38–2.01), despite the heterogeneity among included studies. On sensitivity analysis, the pooled HRs and 95% CIs were not significantly altered when any one study was omitted. The funnel plot for overall survival demonstrated a certain degree of asymmetry, which showed slight publication bias.ConclusionsThis meta-analysis indicates that LVI is significantly associated with poor outcome in patients with bladder cancer who underwent radical cystectomy. Adequately designed prospective studies are required to provide the precise prognostic significance of LVI in bladder cancer.

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

“…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.…”

Perioperative management and oncological outcomes following radical cystectomy for bladder cancer: a matched retrospective cohort study

“…[38][39][40][41] All these risk factors were well balanced between our two study groups, as they were either matched or adjusted; therefore, the comparison between groups accounted for the most important elements that determine the prognosis. Despite that, we failed to find an association between the use of opioid-sparing SA and bladder cancer oncological outcomes.…”

CCR7 as a predictive biomarker associated with computed tomography for the diagnosis of lymph node metastasis in bladder carcinoma

“…In USA, the estimated incidence and number of mortalities associated with bladder cancer in 2012 were 73,510 and 14,880 cases, respectively (12). Thus, the identification of the risks behind disease recurrence and mortality in bladder cancer is critical for adequate surveillance and selection of adjuvant therapies (13,14). Numerous studies have previously investigated potential prognostic factors for patients with bladder cancer, in order to guide therapeutic approaches and improve survival outcomes (15).…”