Validation of lymphovascular invasion is an independent prognostic factor for biochemical recurrence after radical prostatectomy

Harun Fajkovic, Romain Mathieu, Ilaria Lucca, Manuela Hiess, Nicolai Hübner, Bashir Al Hussein Al Awamlh, Richard Lee, Alberto Briganti, Pierre Karakiewicz, Yair Lotan, Morgan Roupret, Michael Rink, Luis Kluth, Wolfgang Loidl, Christian Seitz, Tobias Klatte, Gero Kramer, Martin Susani, Shahrokh F. Shariat

Research output: Contribution to journalArticlepeer-review

18 Scopus citations


Objective: To validate the impact of lymphovascular invasion (LVI) on biochemical recurrence (BCR) in patients treated with radical prostatectomy (RP) in a large multiinstitutional cohort. Material and methods: Retrospective data from 6,678 patients treated with a RP and bilateral lymphadenectomy for prostate cancer (PC) from 8 centers were collected. The primary endpoint was BCR. Results: Overall, 767 patients (11.5%) had LVI. Patients with LVI had significantly higher Gleason scores (P = 0.01). After a median follow-up of 28 months (interquartile range: 21-44), patients with LVI had a 1.66 fold increased risk of BCR (P<0.001). The 1-, 2- and 5-year biochemical recurrence-free survival probabilities for LVI vs. no LVI were 94% vs. 97%, 91% vs. 94%, and 76% vs. 84%, respectively. On multivariable analysis that adjusted for the effects of established prognostic factors, LVI was an independent predictor of BCR (hazard ratio = 1.42, P<0.001). Adding LVI to a multivariable base model increased the discrimination by a small but significant margin (+0.2%, P = 0.0005). In subgroup analyses, LVI remained an independent predictor for BCR in patients with worse pathological features. Conclusions: About 10% of patients with localized PC have LVI on their RP specimen. We confirm that LVI is associated with features of biologic aggressive PC such as high Gleason grade and BCR after RP. Adverse further studies with strict definitions of LVI and longer follow-up periods are needed to determine the prognostic and predictive utility of LVI in the management of PC.

Original languageEnglish (US)
Pages (from-to)233.e1-233.e6
JournalUrologic Oncology: Seminars and Original Investigations
Issue number5
StatePublished - May 1 2016


  • Biochemical recurrence
  • Localized prostate cancer
  • Lymphovascular invasion
  • Radical prostatectomy

ASJC Scopus subject areas

  • Oncology
  • Urology


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