The importance of lymphovascular invasion in patients undergoing radical cystectomy for bladder cancer
John P Stein
Correspondence Department of Urology, Norris Comprehensive Cancer Center, University of Southern California, Keck School of Medicine, 1441 Eastlake Ave, Suite 7416, Los Angeles, CA 90089, USA
Email stein_j@ccnt.hsc.usc.edu
This article has no abstract so we have provided the first paragraph of the full text.
Radical cystectomy is a standard therapy for high-grade invasive bladder cancer.1 This multi-institutional retrospective study of 750 patients undergoing radical cystectomy evaluated the prognostic significance of LVI. LVI was found to be associated with advanced pathologic stage, high-grade tumors and nodal metastases. Most importantly, the presence of LVI at the time of definitive surgery was a significant and independent predictor of survival as well as of local and distant recurrence in node-negative bladder cancers. LVI status did not, however, have predictive value in patients with pathologic node-positive disease. This large series was powered to analyze the data in a multivariate fashion and underscores the potential disease aggressiveness indicated by LVI following cystectomy. The authors suggest that the detection of LVI might help identify patients who are at high risk for recurrence following cystectomy and could therefore benefit from adjuvant therapy. These ideas are best studied in clinical trials.
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