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. 2023 Dec 26;16(1):123.
doi: 10.3390/cancers16010123.

Lymphovascular Invasion at the Time of Radical Prostatectomy Adversely Impacts Oncological Outcomes

Niranjan J Sathianathen  1 , Marc A Furrer  1   2   3   4   5 , Clancy J Mulholland  1 , Andreas Katsios  2 , Christopher Soliman  1   3 , Nathan Lawrentschuk  1   3 , Justin S Peters  1   3 , Homi Zargar  1   3 , Anthony J Costello  1   3   6 , Christopher M Hovens  3   6 , Conrad Bishop  3   7 , Ranjit Rao  1   3 , Raymond Tong  1   3 , Daniel Steiner  3 , Daniel Moon  1   8 , Benjamin C Thomas  1   3   5 , Philip Dundee  1   3   5 , Jose Antonio Rodriguez Calero  9 , George N Thalmann  2 , Niall M Corcoran  1   5   6   10   11
Affiliations

Lymphovascular Invasion at the Time of Radical Prostatectomy Adversely Impacts Oncological Outcomes

Niranjan J Sathianathen et al. Cancers (Basel). .

Abstract

Lymphovascular invasion, whereby tumour cells or cell clusters are identified in the lumen of lymphatic or blood vessels, is thought to be an essential step in disease dissemination. It has been established as an independent negative prognostic indicator in a range of cancers. We therefore aimed to assess the impact of lymphovascular invasion at the time of prostatectomy on oncological outcomes. We performed a multicentre, retrospective cohort study of 3495 men who underwent radical prostatectomy for localised prostate cancer. Only men with negative preoperative staging were included. We assessed the relationship between lymphovascular invasion and adverse pathological features using multivariable logistic regression models. Kaplan-Meier curves and Cox proportional hazard models were created to evaluate the impact of lymphovascular invasion on oncological outcomes. Lymphovascular invasion was identified in 19% (n = 653) of men undergoing prostatectomy. There was an increased incidence of lymphovascular invasion-positive disease in men with high International Society of Urological Pathology (ISUP) grade and non-organ-confined disease (p < 0.01). The presence of lymphovascular invasion significantly increased the likelihood of pathological node-positive disease on multivariable logistic regression analysis (OR 15, 95%CI 9.7-23.6). The presence of lymphovascular invasion at radical prostatectomy significantly increased the risk of biochemical recurrence (HR 2.0, 95%CI 1.6-2.4). Furthermore, lymphovascular invasion significantly increased the risk of metastasis in the whole cohort (HR 2.2, 95%CI 1.6-3.0). The same relationship was seen across D'Amico risk groups. The presence of lymphovascular invasion at the time of radical prostatectomy is associated with aggressive prostate cancer disease features and is an indicator of poor oncological prognosis.

Keywords: lymphovascular invasion; outcomes research; prostate cancer; prostate surgery; prostatectomy.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure A1
Figure A1
Adjusted Kaplan–Meier curves for biochemical recurrence-free survival subgroup analysis based on D’Amico risk groups; (A) high, (B) intermediate.
Figure A2
Figure A2
Adjusted Kaplan–Meir curves for metastases-free survival subgroup analysis based on D’Amico risk groups; (A) high, (B) intermediate.
Figure 1
Figure 1
(A) ISUP grade vs. lymphovascular invasion and (B) pathological T stage vs. lymphovascular invasion.
Figure 2
Figure 2
Adjusted Kaplan–Meier curve for biochemical recurrence-free survival.
Figure 3
Figure 3
Adjusted Kaplan–Meier curve for metastasis-free survival.
See this image and copyright information in PMC

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