Prognostic value of lymphovascular invasion in patients with bladder cancer treated by radical cystectomy

Objective To explore whether lymphovascular invasion can be used as a prognostic indicator in patients with bladder cancer underwent radical cystectomy. Methods The series included clinical data of 459 patients who had underwent radical cystectomy for bladder cancer between January 2006 and December 2012 in our hospital. Among all the patients, 391 were male while 68 were female. Pathological grade G1 was diagnosed in 47, G2 in 104 and G3 in 308. Amount of pathological stage T1 or Tis or Ta or T0 was 167, T2 127, T3 89 and T4 76. Of all the patients, 92 had lymph node metastasis. Follow-up time was between 13 and 99 months. The presence or absence of lymphovascular invasion was determined by HE staining in the radical cystectomy specimen. The χ2 test was used to detect the association between lymphovascular invasion and several clinicopathological features, the Kaplan-Meier method was used to compare recurrence-free survival according to findings of lymphovascular invasion in the surgical specimen, and the multivariate Cox proportional-hazards regression model was used to assess the prognostic significance of some factors. Results Lymphovascular invasion was detected in 128 (28%) specimens. Among them, 44 (34%) had tumor recurrence. Lymphovascular invasion was significantly associated with gender, tumor grade, pathological stage, lymph node metastasis and disease recurrence. Recurrence-free survival in patients without lymphovascular invasion was significantly higher than that in those with lymphovascular invasion (P<0.05). Cox proportional hazards model showed that age, pathological stage and lymph node metastasis were independent predictors for disease recurrence. Conclusion In patients with bladder cancer underwent radical cystectomy, lymphovascular invasion may have a significant association with some prognostic parameters, but it can not be used as an independent predictor of disease recurrence. Key words: Urinary bladder neoplasms; Cystectomy; Prognosis; Lymphovascular invasion