Lymphovascular invasion (LVI) is associated with increased mortality risk among patients undergoing surgery for nonmetastatic renal cell carcinoma (RCC), recent study findings suggest.

The 5-year overall survival (OS) rate was significantly lower in the LVI than no-LVI group (65% vs 86%), a team led by Firas Abdollah, MD, of Vattikuti Urology Institute for Outcomes Research, Analytics, and Evaluation at Henry Ford Hospital in Detroit, Michigan, reported in Urologic Oncology. The 5-year OS rate for patients with LVI vs no LVI was 64% vs 78% among pN0 patients, 31% vs 41% among pN1 patients, and 69% vs 87% among pNx patients.

Compared with patients without LVI, those with LVI had a significant 36% increased risk for death after adjusting for multiple variables. Those with LVI and pN0 disease also had a significant 36% increased risk for death, and patients with LVI and pNx disease had a significant 46% increased risk. Patients with LVI and pN1 disease had a non-significant 18% higher risk.

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“Our findings are the first, to our best knowledge, to illustrate the clear detrimental impact of LVI on OS in surgically treated RCC patients,” Dr Abdollah and colleagues concluded. “These findings might be useful in postoperative patient counseling and need to be accounted for when designing future clinical trials.”

The investigators studied 95,783 patients in the National Cancer Database who underwent partial or radical nephrectomy. Patients had a mean age of 59 years, and 72.2% had pT1 stage disease. The mean renal mass size was 49.6 mm. Overall, 9.0% of patients had LVI. The mean follow-up duration was 39 months. With regard to nodal status, 14.5%, 2.3%, and 83.3% of patients were pN0, pN1, and pNx, respectively.


Rakic I, Rakic N, Stephens A, et al. Assessing the impact of lymphovascular invasion on overall survival in surgically treated renal cell carcinoma patients: a nationwide cohort analysis. Urol Oncol. Published online August 23, 2023. doi:10.1016/j.urolonc.2023.07.011