ORIGINAL ARTICLE
Year : 2016  |  Volume : 18  |  Issue : 5  |  Page : 780-785

The prognostic value of lymphovascular invasion in radical prostatectomy: a systematic review and meta-analysis


1 Department of Urinary Surgery of Changzheng Hospital, Second Military Medical University, Shanghai 200003, China
2 Urology Research Center of the Chinese People's Liberation Army, Changzheng Hospital, Second Military Medical University, Shanghai 200003, China

Correspondence Address:
Dan-Feng Xu
Urology Research Center of the Chinese People's Liberation Army, Changzheng Hospital, Second Military Medical University, Shanghai 200003
China
Xin-Gang Cui
Department of Urinary Surgery of Changzheng Hospital, Second Military Medical University, Shanghai 200003
China
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/1008-682X.156636

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To systematically evaluate the prognostic value of lymphovascular invasion (LVI) in radical prostatectomy (RP) by a meta-analysis based on the published literature. To identify relevant studies, PubMed, Cochrane Library, and Web of Science database were searched from 1966 to May 2014. Finally, 25 studies (9503 patients) were included. LVI was found in 12.2% (1156/9503) of the RP specimens. LVI was found to be correlated with higher pathological tumor stages (greater than pT3 stage) (risk ratio [RR] 1.90, 95% confidence interval [CI] 1.73-2.08, P< 0.00001), higher Gleason scores (greater than GS = 7) (RR 1.30, 95% CI 1.23-1.38, P< 0.00001), positive pathological node (pN) status (RR 5.67, 95% CI 3.14-10.24, P< 0.00001), extracapsular extension (RR 1.72, 95% CI 1.46-2.02, P< 0.00001), and seminal vesicle involvement (RR 3.36, 95% CI 2.41-4.70, P< 0.00001). The pooled hazard ratio (HR) was statistically significant for Biochemical Recurrence-Free (BCR-free) probability (HR 2.05, 95% CI 1.64-2.56; Z = 6.30, P< 0.00001). Sensitivity analysis showed that the pooled HR and 95% CI were not significantly altered by the omission of any single study. Begg's Funnel plots showed no significant publication bias (P = 0.112). In conclusion, LVI exhibited a detrimental effect on the BCR-Free probability and clinicopathological features in RP specimens, and may prove to be an independent prognostic factor of BCR.


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