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Can lymphovascular invasion replace the prognostic value of lymph node involvement in patients with upper tract urothelial carcinoma after radical nephroureterectomy?

 Eun Sang Yoo  ;  Yun-Sok Ha  ;  Jun Nyung Lee  ;  Bum Soo Kim  ;  Bup Wan Kim  ;  Seok-Soo Byun  ;  Young Deuk Choi  ;  Ho Won Kang  ;  Seok-Joong Yun  ;  Wun-Jae Kim  ;  Jeong Hyun Kim  ;  Tae Gyun Kwon 
 Canadian Urological Association Journal, Vol.10(7~8) : 229-236, 2016 
Journal Title
 Canadian Urological Association Journal 
Issue Date
INTRODUCTION: This study aimed to evaluate whether lymphovascular invasion (LVI) can replace lymph node (LN) involvement as a prognostic marker in patients who do not undergo lymph node dissection (LND) during surgery in patients with upper tract urothelial carcinoma (UTUC). METHODS: A total of 505 patients who underwent radical nephroureterectomy (RNU) were recruited from four academic centres and divided into four groups: node negative (N0, Group 1); node positive (N+, Group 2); no LND without LVI (NxLVI-, Group 3); and no LND with LVI (NxLVI+, Group 4). RESULTS: Patients in Group 2 had larger tumours, a higher incidence of left-sided involvement, more aggressive T stage and grade, and a higher positive surgical margin rate than patients in other groups. Pathological features (T stage and grade) were poorer in Group 4 than in Groups 1 and 3. Compared to other groups, Group 2 had the worst prognostic outcomes regarding locoregional/distant metastasis-free survival (MFS), cancer-specific survival (CSS), and overall survival (OS). LVI and LN status in Group 4 was not associated with MFS in multivariate analysis. Among Nx diseases, LVI was not an independent predictor of MFS or CCS. The small number of cases in Groups 2 and 4 is a major limitation of this study. CONCLUSIONS: Clinical outcomes according to LVI did not correlate with those outcomes predicted by LN involvement in patients with UTUC. Therefore, LVI may not be used as a substitute for nodal status in patients who do not undergo LND at the time of surgery.
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1. College of Medicine (의과대학) > Dept. of Urology (비뇨의학교실) > 1. Journal Papers
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Choi, Young Deuk(최영득) ORCID logo https://orcid.org/0000-0002-8545-5797
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