Impact of Lymphovascular Invasion on Survival in UTUC: A Nationwide Analysis

What is it about?

This study analyzed the impact of lymphovascular invasion (LVI) on overall survival in 5940 patients with clinical M0 upper tract urothelial carcinoma who underwent radical nephroureterectomy between 2010 and 2016 in the National Cancer Database. LVI was found in 22.1% of patients and was associated with less favorable survival outcomes. The study also found that nodal status greatly impacted survival outcomes, and the absence of LVI could be used as a proxy for pN0 status. The study's large sample size and nationwide scope make it a valuable addition to the literature on LVI and survival outcomes in upper tract urothelial carcinoma. [Some of the content on this page has been created by AI]

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Why is it important?

This research is important because it provides valuable insights into the prognostic ability of lymphovascular invasion (LVI) in patients with upper tract urothelial carcinoma (UTUC) after undergoing a radical nephroureterectomy (RNU). The study demonstrates that LVI is an independent predictor of overall survival (OS) in patients with UTUC, which can help in counseling patients about their prognosis and potentially aid in future trials to risk-stratify patients. Key Takeaways: 1. LVI is an established adverse pathological finding in UTUC. 2. The impact of LVI on OS has not been well defined in previous studies due to limitations such as small sample size, limited duration of follow-up, and being institutional in nature. 3. In this large, nationwide cohort, LVI was found to be associated with less favorable OS in patients with surgically treated UTUC. 4. When stratifying based on pathological nodal (pN) status, the impact of LVI on OS held true in pN0 and pNx patients, but not in those with pN1 disease. 5. LVI could be used as a prognostic factor in counseling patients about their prognosis and as a useful tool for future trials to risk-stratify patients.