Lymphovascular Invasion Is Independently Associated With Overall Survival, Cause-Specific Survival, and Local and Distant Recurrence in Patients With Negative Lymph Nodes at Radical Cystectomy

Purpose We hypothesized that bladder cancer patients with associated lymphovascular invasion (LVI) are at increased risk of occult metastases. Methods A multi-institutional group (University of Texas Southwestern [Dallas, TX], Baylor College of Medicine [Houston, TX], Johns Hopkins University [Baltimore, MD]) carried out a retrospective study of 958 patients who underwent cystectomy for bladder cancer between 1984 and 2003. Of patients with transitional-cell carcinoma (n = 776), LVI status was available for 750. LVI was defined as the presence of tumor cells within an endothelium-lined space. Results LVI was present in 36.4% (273 of 750) overall, involving 26% (151 of 581) and 72% (122 of 169) of node-negative and node-positive patients, respectively. Prevalence of LVI increased with higher pathologic stage (9.0%, 23%, 60%, and 78%, for T1, T2, T3, and T4, respectively; P < .001). Using multivariate Cox regression analyses including age, stage, grade, and number of pelvic lymph nodes removed, LVI was an i...

[1]  Alberto Redaelli,et al.  Bladder cancer: epidemiology, diagnosis, and management. , 2002, Cancer practice.

[2]  R. Dodge,et al.  The value of pathologic factors in predicting cancer‐specific survival among patients treated with radical cystectomy for transitional cell carcinoma of the bladder and prostate , 1993, Cancer.

[3]  H. Wolf,et al.  Prognostic significance of vascular and perineural invasion in urothelial bladder cancer treated with radical cystectomy. , 2003, The Journal of urology.

[4]  T. Wheeler,et al.  Preoperative plasma levels of interleukin-6 and its soluble receptor predict disease recurrence and survival of patients with bladder cancer. , 2002, The Journal of urology.

[5]  R. Millikan,et al.  Integrated therapy for locally advanced bladder cancer: final report of a randomized trial of cystectomy plus adjuvant M-VAC versus cystectomy with both preoperative and postoperative M-VAC. , 2001, Journal of clinical oncology : official journal of the American Society of Clinical Oncology.

[6]  Nicholas J Vogelzang,et al.  Neoadjuvant chemotherapy plus cystectomy compared with cystectomy alone for locally advanced bladder cancer. , 2003, The New England journal of medicine.

[7]  A. Jemal,et al.  Cancer Statistics, 2004 , 2004, CA: a cancer journal for clinicians.

[8]  J. Stein,et al.  The evolving role of pelvic lymphadenectomy in the treatment of bladder cancer. , 2004, Urologic oncology.

[9]  S. Groshen,et al.  Radical cystectomy in the treatment of invasive bladder cancer: long-term results in 1,054 patients. , 2001, Journal of clinical oncology : official journal of the American Society of Clinical Oncology.

[10]  H. Grossman,et al.  A stage specific approach to tumor surveillance after radical cystectomy for transitional cell carcinoma of the bladder. , 1999, The Journal of urology.

[11]  T. Wheeler,et al.  Association of plasma urokinase-type plasminogen activator and its receptor with clinical outcome in patients undergoing radical cystectomy for transitional cell carcinoma of the bladder. , 2003, Urology.

[12]  H. Miyake,et al.  Prognostic variables in patients who have undergone radical cystectomy for transitional cell carcinoma of the bladder. , 2001, Japanese journal of clinical oncology.

[13]  T. Wheeler,et al.  Preoperative plasma soluble E-cadherin predicts metastases to lymph nodes and prognosis in patients undergoing radical cystectomy. , 2003, The Journal of urology.

[14]  P. Bassi,et al.  Prognostic factors of outcome after radical cystectomy for bladder cancer: a retrospective study of a homogeneous patient cohort. , 1999, The Journal of urology.

[15]  M. Benson,et al.  The effect of cystectomy, and perioperative methotrexate, vinblastine, doxorubicin and cisplatin chemotherapy on the risk and pattern of relapse in patients with muscle invasive bladder cancer. , 2000, The Journal of urology.

[16]  S. Lerner,et al.  Radical cystectomy in regionally advanced bladder cancer. , 1992, The Urologic clinics of North America.

[17]  S. Johansson,et al.  The significance of lamina propria invasion on the prognosis of patients with bladder tumors. , 1980, The Journal of urology.

[18]  P. Carroll,et al.  Tumor angiogenesis correlates with lymph node metastases in invasive bladder cancer. , 1995, The Journal of urology.

[19]  M W Kattan,et al.  Preoperative plasma levels of transforming growth factor β1 strongly predict clinical outcome in patients with bladder carcinoma , 2001, Cancer.

[20]  R. Babaian,et al.  Adjuvant cyclophosphamide, doxorubicin, and cisplatin chemotherapy for bladder cancer: an update. , 1988, Journal of clinical oncology : official journal of the American Society of Clinical Oncology.