title: Prognostic significance of vascular invasion in patients with bladder cancer who underwent radical cystectomy.
abstract: BACKGROUND
  The objective of this study was to determine whether vascular invasion (i.e. lymphatic and blood vessel invasion) could be a useful prognostic predictor in patients with locally invasive transitional cell carcinoma (TCC) of the bladder who underwent radical cystectomy.
  
  
  METHODS
  This series included 114 consecutive patients undergoing radical cystectomy for primary TCC of the bladder between November 1989 and July 2003. Several clinicopathological characteristics of these patients were analyzed, focusing on the association between vascular invasion and disease recurrence after radical cystectomy.
  
  
  RESULTS
  Lymphatic and blood vessel invasions were detected in 55 (48.2%) and 33 (29.8%) specimens, respectively. Lymphatic invasion was significantly associated with pathological stage, tumor grade, lymph node metastasis, blood vessel invasion and disease recurrence, whereas blood vessel invasion was significantly related to pathological stage, lymph node metastasis, lymphatic invasion and disease recurrence. Recurrence-free survival in patients with lymphatic invasion was significantly lower than that in those without lymphatic invasion, and a similar significant difference in recurrence-free survival was observed between patients with and without blood vessel invasion. However, multivariate analysis using the Cox proportional hazards model showed that only pathological stage and lymph node metastasis could be used as independent predictors for disease recurrence after radical cystectomy.
  
  
  CONCLUSIONS
  Despite a significant association between several prognostic parameters, vascular invasion was not an independent predictor of disease recurrence; therefore, if there are other conventional parameters available, there might not be any additional advantage to considering the presence of vascular invasion when predicting the prognosis of patients undergoing radical cystectomy for TCC of the bladder.
authors.affiliation: Department of Urology, Hyogo Medical Center for Adults, Akashi, Japan.
authors.forename: Ken-Ichi
authors.initials: K
authors.lastname: Harada
authors.forename: Iori
authors.initials: I
authors.lastname: Sakai
authors.forename: Isao
authors.initials: I
authors.lastname: Hara
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Eto
authors.forename: Hideaki
authors.initials: H
authors.lastname: Miyake
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002295:Carcinoma, Transitional Cell / Q000556:secondary* / Q000601:surgery; D015653:Cystectomy; D005260:Female; D006801:Humans; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D009364:Neoplasm Recurrence, Local / Q000473:pathology*; D011237:Predictive Value of Tests; D011379:Prognosis; D012189:Retrospective Studies; D001749:Urinary Bladder Neoplasms / Q000473:pathology* / Q000601:surgery; D019043:Vascular Neoplasms / Q000556:secondary*