Shariat, Shahrokh F. and Svatek, Robert S. and Tilki, Derya and Skinner, Eila and Karakiewicz, Pierre I. and Capitanio, Umberto and Bastian, Patrick J. and Volkmer, Bjoern G. and Kassouf, Wassim and Novara, Giacomo and Fritsche, Hans-Martin and Izawa, Jonathan I. and Ficarra, Vincenzo and Lerner, Seth P. and Sagalowsky, Arthur I. and Schoenberg, Mark P. and Kamat, Ashish M. and Dinney, Colin P. and Lotan, Yair and Marberger, Michael J. and Fradet, Yves (2010) International validation of the prognostic value of lymphovascular invasion in patients treated with radical cystectomy. BJU INTERNATIONAL, 105 (10). pp. 1402-1412. ISSN 1464-4096,
Full text not available from this repository. (Request a copy)Abstract
OBJECTIVE To externally validate the prognostic value of lymphovascular invasion (LVI) in a large international cohort of patients treated with radical cystectomy (RC) for urothelial carcinoma of the bladder (UCB). PATIENTS AND METHODS We collected data from 4257 patients treated with RC and pelvic lymphadenectomy for UCB, without neoadjuvant chemotherapy, at 12 centres. LVI was defined as presence of nests of tumour cells within an endothelium-lined space. RESULTS LVI was detected in 1407 patients (33.1%); the proportion of LVI increased with advancing stage, higher grade, soft-tissue surgical margin involvement, and lymph node metastasis (P < 0.001 for all). In standard multivariate models, LVI was associated with both disease recurrence (hazard ratio 1.43, P < 0.001) and cancer-specific mortality (1.45, P < 0.001). In the entire cohort, adding LVI to a base model that included standard features improved only minimally its predictive accuracy for both recurrence and cancer-specific mortality (by 1.1% and 1.2%, respectively). In 3122 patients with negative lymph nodes, LVI remained independently associated with and improved the predictive accuracy of the standard predictors for recurrence (hazard ratio 1.68, P < 0.001; +2.3%) and cancer-specific mortality (1.70, P < 0.001; +2.4%). By contrast, in 1071 node-positive patients, LVI only marginally improved the prediction of cancer-specific recurrence (hazard ratio 1.20, P < 0.001; +0.2%) and survival (1.23, P < 0.001; +0.5%). CONCLUSIONS LVI is strongly associated with clinical outcome in node-negative patients treated with RC. The assessment of LVI might help to identify patients who could benefit from adjuvant therapy after RC. After confirmation in different populations, LVI should be included in the staging of UCB.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | PERITUMORAL LYMPHATIC INVASION; TRANSITIONAL-CELL-CARCINOMA; BLADDER-CANCER; PERINEURAL INVASION; STAGE-I; LYMPHANGIOGENESIS; METASTASIS; ADENOCARCINOMA; SPECIMENS; lymphovascular invasion; prognosis; bladder cancer; urothelial carcinoma; survival; recurrence |
| Subjects: | 600 Technology > 610 Medical sciences Medicine |
| Divisions: | Medicine > Lehrstuhl für Urologie |
| Depositing User: | Dr. Gernot Deinzer |
| Date Deposited: | 03 Aug 2020 05:09 |
| Last Modified: | 03 Aug 2020 05:09 |
| URI: | https://pred.uni-regensburg.de/id/eprint/24758 |
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