To analyze the prognostic impact of lymphovascular invasion (LVI) in case of urothelial carcinoma of upper urinary tract (UUT-UC).
Patients and methods
Retrospective study of 83 consecutive patients treated surgically for UUT-UC between January 1998 and October 2008. Prognostic interest of histopathological factors (stage, grade, LVI, CIS, tumor architecture, location, nodal status and surgical margins) was assessed in univariate and multivariate Cox regression model. Specific survival (SS), recurrence-free survival (RFS) and metastasis-free survival (MFS) were calculated using Kaplan-Meier method and Log-Rank test.
LVI was observed in 26.5% of patients after histopathologic reviewing. The SS, RFS and MFS at 2 years were 93%, 76% and 96% respectively in group without LVI compared to 40%, 13% and 38% in group with LVI (P <0.001). In univariate analysis, pathological stage, LVI and margin status were predictive of SS (P <0.05). Pathological stage, LVI and surgical margin status were predictive of RFS (P <0.05). LVI, tumor architecture and status of surgical margins were predictive of MFS (P <0.05). LVI was the only independent predictive factor in multivariate analysis for all survival (P =0.002, 0.002 and 0.001 respectively for the SS, RFS and MFS).
LVI was a poor prognostic factor in cases of UUT-UC. This criteria should be routinely sought and included in the pathology report.