title: Lymphovascular invasion is associated with oncologic outcomes following radical cystectomy for squamous cell carcinoma of the urinary bladder.
abstract: To evaluate the association of lymphovascular invasion (LVI) with oncologic outcomes of squamous cell carcinoma (SCC) of the urinary bladder following radical cystectomy (RC).
  
  
  
  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.
  
  
  
  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).
  
  
  
  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.
authors.affiliation: Department of Urology, University of California-Irvine, Orange, CA.
authors.forename: Kyle
authors.initials: K
authors.lastname: Spradling
authors.affiliation: Department of Urology, University of Texas Southwestern Medical Center, Dallas, TX.
authors.forename: Yair
authors.initials: Y
authors.lastname: Lotan
authors.affiliation: Department of Urology, Urology and Nephrology Center, Mansoura University, Mansoura, Egypt.
authors.forename: Ahmed
authors.initials: A
authors.lastname: Shokeir
authors.affiliation: Department of Urology, Urology and Nephrology Center, Mansoura University, Mansoura, Egypt.
authors.forename: Hassan
authors.initials: H
authors.lastname: Abol-Enein
authors.affiliation: Department of Urology, Urology and Nephrology Center, Mansoura University, Mansoura, Egypt.
authors.forename: Ahmed
authors.initials: A
authors.lastname: Mosbah
authors.affiliation: Department of Urology, University of California-Irvine, Orange, CA.
authors.forename: Jacob B
authors.initials: JB
authors.lastname: Morgan
authors.affiliation: Department of Urology, Urology and Nephrology Center, Mansoura University, Mansoura, Egypt.
authors.forename: Mohamed
authors.initials: M
authors.lastname: Ghoneim
authors.affiliation: Department of Urology, University of California-Irvine, Orange, CA. Electronic address: ryaacoub@uci.edu.
authors.forename: Ramy F
authors.initials: RF
authors.lastname: Youssef
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000473:pathology* / Q000601:surgery*; D015653:Cystectomy; D004534:Egypt; D005260:Female; D006801:Humans; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D009367:Neoplasm Staging; D011379:Prognosis; D012189:Retrospective Studies; D001749:Urinary Bladder Neoplasms / Q000473:pathology* / Q000601:surgery*; D055815:Young Adult
keywords: Bladder cancer; Lymphovascular invasion; Squamous cell carcinoma; Urothelial carcinoma