Lymphovascular invasion is associated with oncologic outcomes following radical cystectomy for squamous cell carcinoma of the urinary bladder

Objective To evaluate the association of lymphovascular invasion (LVI) with oncologic outcomes of squamous cell carcinoma (SCC) of the urinary bladder following radical cystectomy (RC). Patients and methods We performed a retrospective analysis of 1,280 patients who underwent RC for invasive bladder cancer between 1997 and 2003 in Mansoura, Egypt. Only patients with pure urothelial carcinoma of the bladder (UCB) or SCC pathology were included. Using multivariate Cox regression analyses and Kaplan-Meier analyses, prognostic significance of LVI in disease-free survival and cancer-specific survival was evaluated for patients with UCB and SCC. Results Our cohort included 519 (59%) patients with UCB and 360 (41%) with SCC. Median patient age and follow-up were 55 years (20–87) and 64 months (0–128), respectively. Median number of lymph nodes (LN) retrieved was 19 (4–70). LVI was present in 288 (32.8%) patients (241 [46.4%] UCB vs. 47 [13.1%] SCC; P<0.001). LVI was an independent predictor of oncologic outcomes in both UCB and SCC groups; however, LVI had more prognostic significance in SCC. LN negative, LVI positive (LVI+/LN−) patients with SCC had higher risk of recurrence and cancer-specific mortality compared to LN positive, LVI negative (LVI−/LN+) patients with SCC (hazard ratio = 2.8 vs. 1.9 and hazard ratio = 3.6 vs. 2.2, respectively). Conclusion The presence of LVI is an independent predictor of poor oncologic outcomes after RC and had greater prognostic significance in patients with SCC compared to UCB.