Prognostic Value of Lymphovascular Invasion in Node-Negative Upper Urinary Tract Urothelial Carcinoma Patients Undergoing Radical Nephroureterectomy
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Purpose: This study aimed to evaluate the prognostic impact of lymphovascular invasion (LVI) in patients treated with radicalnephroureterectomy (RNU) for upper urinary tract urothelial carcinoma (UTUC). Materials and Methods: We collected data from 180 patients who were treated with RNU from 2005 to 2013 at our institution. TheKaplan-Meier method with log-rank test and Cox proportional hazards regression models were used for univariate and multivariateanalyses. Results: LVI was present in 28 patients (15.6%), which was associated with higher pathological tumor stage (p<0.001), tumor necrosis(p=0.012), lymph node metastasis (p=0.017) and multifocality (p=0.012). On multivariate analysis, LVI was an independentprognostic factor of recurrence-free survival [RFS: hazard ratio (HR)=2.954; 95% confidence interval (CI)=1.539–5.671; p=0.001]and cancer-specific survival (CSS: HR=3.530; 95% CI=1.701–7.325; p=0.001) in all patients. In patients with node-negative UTUC,LVI was also a significant predictor of RFS (HR=3.732; 95% CI 1.866–7.464; p<0.001) and CSS (HR=3.825; 95% CI=1.777–8.234;p=0.001). Conclusion: LVI status was an independent predictor in patients with UTUC who underwent RNU. The estimate of LVI couldhelp physicians identify high-risk patients and make a better medication regimen of adjuvant chemotherapy.
Abstract
Purpose: This study aimed to evaluate the prognostic impact of lymphovascular invasion (LVI) in patients treated with radicalnephroureterectomy (RNU) for upper urinary tract urothelial carcinoma (UTUC). Materials and Methods: We collected data from 180 patients who were treated with RNU from 2005 to 2013 at our institution. TheKaplan-Meier method with log-rank test and Cox proportional hazards regression models were used for univariate and multivariateanalyses. Results: LVI was present in 28 patients (15.6%), which was associated with higher pathological tumor stage (p<0.001), tumor necrosis(p=0.012), lymph node metastasis (p=0.017) and multifocality (p=0.012). On multivariate analysis, LVI was an independentprognostic factor of recurrence-free survival [RFS: hazard ratio (HR)=2.954; 95% confidence interval (CI)=1.539–5.671; p=0.001]and cancer-specific survival (CSS: HR=3.530; 95% CI=1.701–7.325; p=0.001) in all patients. In patients with node-negative UTUC,LVI was also a significant predictor of RFS (HR=3.732; 95% CI 1.866–7.464; p<0.001) and CSS (HR=3.825; 95% CI=1.777–8.234;p=0.001). Conclusion: LVI status was an independent predictor in patients with UTUC who underwent RNU. The estimate of LVI couldhelp physicians identify high-risk patients and make a better medication regimen of adjuvant chemotherapy.
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