title: The prognostic value of lymphovascular invasion in radical prostatectomy: a systematic review and meta-analysis.
abstract: 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.
authors.affiliation: Department of Urinary Surgery of Changzheng Hospital, Second Military Medical University, Shanghai 200003, China.
authors.forename: Yi
authors.initials: Y
authors.lastname: Huang
authors.affiliation: Department of Urinary Surgery of Changzheng Hospital, Second Military Medical University, Shanghai 200003, China.
authors.forename: Hai
authors.initials: H
authors.lastname: Huang
authors.affiliation: Department of Urinary Surgery of Changzheng Hospital, Second Military Medical University, Shanghai 200003, China.
authors.forename: Xiu-Wu
authors.initials: XW
authors.lastname: Pan
authors.affiliation: Urology Research Center of the Chinese People's Liberation Army, Changzheng Hospital, Second Military Medical University, Shanghai 200003, China.
authors.forename: Dan-Feng
authors.initials: DF
authors.lastname: Xu
authors.affiliation: Department of Urinary Surgery of Changzheng Hospital, Second Military Medical University, Shanghai 200003, China.
authors.forename: Xin-Gang
authors.initials: XG
authors.lastname: Cui
authors.affiliation: Department of Urinary Surgery of Changzheng Hospital, Second Military Medical University, Shanghai 200003, China.
authors.forename: Jie
authors.initials: J
authors.lastname: Chen
authors.affiliation: Department of Urinary Surgery of Changzheng Hospital, Second Military Medical University, Shanghai 200003, China.
authors.forename: Yi
authors.initials: Y
authors.lastname: Hong
authors.affiliation: Department of Urinary Surgery of Changzheng Hospital, Second Military Medical University, Shanghai 200003, China.
authors.forename: Yi
authors.initials: Y
authors.lastname: Gao
authors.affiliation: Department of Urinary Surgery of Changzheng Hospital, Second Military Medical University, Shanghai 200003, China.
authors.forename: Lei
authors.initials: L
authors.lastname: Yin
authors.affiliation: Department of Urinary Surgery of Changzheng Hospital, Second Military Medical University, Shanghai 200003, China.
authors.forename: Jian-Qing
authors.initials: JQ
authors.lastname: Ye
authors.affiliation: Department of Urinary Surgery of Changzheng Hospital, Second Military Medical University, Shanghai 200003, China.
authors.forename: Lin
authors.initials: L
authors.lastname: Li
mesh_terms: D006801:Humans; D008207:Lymphatic Metastasis / Q000473:pathology*; D008297:Male; D009361:Neoplasm Invasiveness / Q000473:pathology*; D011379:Prognosis; D011468:Prostatectomy; D011471:Prostatic Neoplasms / Q000473:pathology* / Q000601:surgery