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. 2024 Oct 11:14:1417630.
doi: 10.3389/fonc.2024.1417630. eCollection 2024.

Microvascular invasion is associated with poor prognosis in renal cell carcinoma: a retrospective cohort study and meta-analysis

Jinbin Xu #  1 , Yiyuan Tan #  2 , Shuntian Gao  1 , Weijen Lee  1 , Yuedian Ye  1 , Gengguo Deng  1 , Zhansen Huang  1 , Xiaoming Li  1 , Jiang Li  1 , Samun Cheong  1 , Jinming Di  1
Affiliations

Microvascular invasion is associated with poor prognosis in renal cell carcinoma: a retrospective cohort study and meta-analysis

Jinbin Xu et al. Front Oncol. .

Abstract

Background: This retrospective cohort study and meta-analysis aims to explore the association between microvascular invasion (MVI) and clinicopathologiccal features, as well as survival outcomes of patients with renal cell carcinoma (RCC).

Material and methods: The retrospective cohort study included 30 RCC patients with positive MVI and another 75 patients with negative MVI as controls. Clinicopathological features and follow-up data were compiled. The meta-analysis conducted searches on PubMed, Cochrane Library, Web of Science, Embase, and WanFang Data from the beginning to 30 September 2023, for comparative studies relevant to MVI patients. The Newcastle-Ottawa Scale and Egger Test were used to assess the risk of biases and certainty of evidence in the included studies.

Results: The cohort study showed that MVI was associated with advanced primary tumor stage, high pathological grades, high tumor size, high clinical symptoms and lymph node invasion (P <0.05). Kaplan-Meier analyses demonstrated MVI was associated with worse CSS rates when compared to MVI negative group (P <0.05). However, in the multivariate analysis it was not presented as an independent predictor of cancer survival mortality (P >0.05). The meta-analysis part included 11 cohort studies. The results confirmed that patients with MVI positive had worse 12 and 60 mo CSS rates (HR12mo = 0.86, 95%CI 0.80-0.92; HR60mo = 0.63, 95% CI 0.55-0.72; P < 0.00001). Moreover, the meta-analysis also confirmed that MVI group was associated with higher rate of advanced tumor stage, pathological grades, tumor size diameter, higher rate of clinical symptoms and lymph node invasion (P <0.05).

Conclusions: The presence of MVI in renal cell carcinoma patients is linked to poorer survival outcomes and worse clinicopathological features. In spite of this, it does not seem to be an independent predictor for cancer survival mortality in renal cell carcinoma.

Systematic review registration: https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42023470640, identifier CRD42023470640.

Keywords: cancer-specific survival; cohort studies; meta-analysis; microvascular invasion; renal cell carcinoma.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. The reviewer JK declared a shared parent affiliation with the authors JX, SG, WL, YY, GD, ZH, XL, JL, SC, JD to the handling editor at the time of review.

Figures

Figure 1
Figure 1
Cancer-specific survival in patients with MVI positive vs MVI negative.
Figure 2
Figure 2
Study selection flowchart.
Figure 3
Figure 3
Forest plot of outcomes between the MVI positive and MVI negative. (A) 12 mo cancer-specific survival rate, (B) 60 mo cancer-specific survival rate, (C) 12 mo cancer-specific survival rate of non-metastatic RCC group, and (D) 60 mo cancer-specific survival rate of non-metastatic RCC group.
Figure 4
Figure 4
Forest plot of outcomes between the MVI positive and MVI negative. (A) 12 mo disease-free survival rate, and (B) 60 mo disease-free survival rate, (C) the rate of advanced pathological grade, (D) the rate of advanced tumor classification.
Figure 5
Figure 5
Forest plot of outcomes between the MVI positive and MVI negative. (A) the rate of large tumor diameter, (B) the rate of lymph node metastasis, (C) the rate of peripheral fat invasion, and (D) the rate of clinical symptom.
See this image and copyright information in PMC

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