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Meta-Analysis
. 2017 Jul 11;8(28):46565-46579.
doi: 10.18632/oncotarget.15425.

Lymphovascular invasion is a high risk factor for stage I/II colorectal cancer: a systematic review and meta-analysis

Hang Yuan  1   2 , Quanjin Dong  1 , Bo'an Zheng  1 , Xinye Hu  1 , Jian-Bo Xu  3 , Shiliang Tu  1
Affiliations
Meta-Analysis

Lymphovascular invasion is a high risk factor for stage I/II colorectal cancer: a systematic review and meta-analysis

Hang Yuan et al. Oncotarget. .

Abstract

The prognostic value of lymphovascular invasion (LVI) in stage I/II colorectal cancer (CRC) does not reach a consensus. To systematically assess prognostic significance of LVI, databases of PubMed, Web of Science, and Embase were searched from inception up to 10 Dec 2016. The pooled hazard ratio (HR) and 95% confidence intervals (CI) were used to determine the prognostic effects. Nineteen relevant studies including 9881 total patients were enrolled. Our results showed that LVI is significantly associated with poor prognosis in overall survival (OS) (HR=2.15, 95 % CI=1.72-2.68, P < 0.01) and disease-free survival (DFS) (HR=1.73, 95% CI=1.50-1.99, P < 0.01), which is similar in stage II patients. Further subgroup analysis revealed that the significance of the association between LVI and worse prognosis in CRC patients is not affected by below factors, including geographic setting, LVI positive rate, treatment, tumor site, and quality of the study. The current meta-analysis suggests that LVI may be a poor prognostic factor for stage I/II CRC patients.

Keywords: colorectal cancer; lymphovascular invasion; meta-analysis; stage I/II; survival.

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Conflict of interest statement

CONFLICTS OF INTEREST

The authors have no conflicts of interest to declare.

Figures

Figure 1
Figure 1. Flow diagram of literature search and study selection
Figure 2
Figure 2. Forest plot of the hazard ratio for the association of lymphovascular invasion with overall survival in colorectal cancer patients
Figure 3
Figure 3. Forest plot of the hazard ratio for the association of lymphovascular invasion with disease free survival in colorectal cancer patients
Figure 4
Figure 4. Galbraith plot analysis in overall survival
Figure 5
Figure 5
Forest plot of cumulative meta-analysis of the association of lymphovascular invasion with overall survival (A) and disease free survival (B) in colorectal cancer patients.
Figure 6
Figure 6
The results of sensitivity analysis of overall survival (A) and disease free survival (B) showing the effect of each study on the overall estimate by sequentially excluding one study in one turn.
Figure 7
Figure 7. Funnel plot analysis
A. Funnel plot analysis of 9 studies on overall survival. B. Funnel plot analysis of 13 studies on disease free survival.
Figure 8
Figure 8. Begg's funnel plot on overall survival (A) and disease free survival (B)
Figure 9
Figure 9. Egger's publication bias plot on overall survival (A) and disease free survival (B)
Figure 10
Figure 10. Trim-and-fill funnel plot on overall survival (A) and disease free survival (B)
See this image and copyright information in PMC

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