Revisiting the role of lymphovascular invasion in prostate cancer: a narrative review

Lymphovascular invasion (LVI) is an adverse histopathological marker in prostate cancer, associated with increased risks of disease progression and biochemical recurrence. Despite its established value as an independent predictive factor, LVI remains underutilized in clinical decision-making. In particular, LVI identified in radical prostatectomy specimens does not currently influence management strategies, even though numerous studies highlight its critical role in patient outcomes. This review synthesizes recent literature on the clinical significance of LVI in prostate cancer, emphasizing its relationship with biochemical recurrence, lymph node invasion, and survival parameters. Future directions highlight the need for larger prospective studies, standardized definitions, and AI-driven histopathological tools to enhance the detection and integration of LVI into clinical practice.