Abstract:

Objective: We aimed to investigate the effects of lymphovascular invasion (LVI) on survival rate, as well as the relationship of this parameter with lymph node (LN) involvement and other prognostic factors, in patients undergoing radical cystectomy (RC) for bladder cancer. Materials and Methods: Patients who underwent RC in our clinic for muscle invasive bladder cancer (MIBC) or high-risk non-muscle invasive bladder cancer (NMIBC) between 2006 and 2019 were retrospectively reviewed. Patients were divided into four groups: LVI (−) and LN (−) patients were in group 1, LVI (+) and LN (−) patients were in group 2, LVI (−) and LN (+) patients were in group 3, and LVI (+) and LN (+) patients were in group 4. All data were compared among the groups. Results: A total of 177 patients with a mean age of 64.4 years and mean follow-up time of 30.2 months were evaluated in this study. The mean overall survival (OS) and cancer-specific survival (CSS) of the patients were 56.6±4.2 and 68.9±4.5 months, respectively. When factors affecting survival rates were analyzed, LN positivity was not a significant factor influencing the OS (p=0.570) and CSS (p=0.533) of the patients. However, LVI [p=0.002, hazard ratio (HR)=0.402] and surgical margin (SM) positivity (p=0.001, HR=0.321) were significant factors influencing OS. SM positivity (p=0.003, HR=0.314), LVI (p=0.011, HR=0.416), and adjuvant chemotherapy (ACT) (p=0.009, HR=0.460) were also found to be independent factors affecting CSS. ACT was higher in group 3 than in other groups, and overall and cancer-specific mortality rates were lower in group 1 than in other groups. OS and CSS in group 2 (15.3±2.9 and 21.2±4.6 months, respectively) and group 4 (21.5±7.2 and 24.5±8.1 months, respectively) were lower than those in other groups (p<0.001). Conclusion: SM positivity and LVI are independent factors affecting OS and CSS. ACT, especially in group 3, could increase CSS. OS and CSS were lower in patients with LVI than in those without.

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