Lymphovascular Invasion Is Independently Associated With Cancer Recurrence And Survival In Patients With Negative Lymph Nodes At Radical Nephroureter

Main Category: Urology / Nephrology
Also Included In: Cancer / Oncology
Article Date: 08 Jun 2008 - 0:00 PDT

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ORLANDO, FL (UroToday.com) - Invasion of the lymphovascular channels is a necessary gateway to the metastatic process. Does lymphovascular invasion (LVI) on final pathology following extirpation of upper tract TCC predict disease progression?

Given the low incidence of upper tract urothelial lesions only a collaborative effort by a multi-institutional team could answer this question. Indeed, this study by an impressive international group of authors reports on data collected from 1363 (!) patients, 338 (25%) of whom had LVI, who were treated with nephroureterectomy in Tokyo (Japan), Houston (USA), Milan (Italy), Montreal (Canada), Dallas (USA), Graz (Austria), Mannheim (Germany), New York (USA), Vienna (Austria), Ann Arbor (USA), Sacramento (USA), Rennes (France), and Santiago (Chile)!

All pathologic data was re-reviewed by genitourinary pathologists! Not only did presence of LVI correlate with high tumor stage, tumor grade, sessile architecture, concomitant CIS, lymph node metastasis, and symptoms at presentation, in a multivariate analysis LVI was also an independent predictor of disease recurrence and cancer-specific survival.

The authors conclude that presence of LVI on final pathology following nephroureterectomy could be used to risk-stratify patients and to select individuals for adjuvant chemotherapy treatment. A different group, in a separate abstract on Tuesday will report on a similar role of LVI in predicting disease progression following cystectomy (Abstract 1611).

Presented by Eiji Kikuchi, MD, et al., at the Annual Meeting of the American Urological Association (AUA) - May 17 - 22, 2008. Orange County Convention Center - Orlando, Florida, USA.

Reported by UroToday.com Contributing Editor Alexander Kutikov, MD

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