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Purpose <p>To assess the prognostic significance of lymphovascular invasion (LVI) in patients with renal cell carcinoma (RCC), stratified by nodal status (N0 vs. N1), and to evaluate its influence on survival and perioperative outcomes.</p> Materials and Methods <p>A retrospective review was conducted of 2787 patients with clinical T1–2 RCC who underwent nephrectomy at a single tertiary center. Patients were categorized by LVI status and pathologic nodal stage (N0 or N1). Clinicopathological features, perioperative outcomes, and oncologic endpoints—including recurrence-free survival (RFS), disease-specific survival (DSS), and overall survival (OS)—were analyzed using Kaplan–Meier analysis and Cox proportional hazards models.</p> Results <p>Among N0 patients, LVI-positive tumors were associated with adverse preoperative markers, higher Fuhrman grades, larger tumor sizes, and poorer perioperative outcomes. These associations were not observed in N1 patients. Kaplan–Meier analysis demonstrated significantly lower RFS, DSS, and OS among patients with LVI in the N0 group (all <i>p</i> &lt; 0.001), but not in the N1 group. In multivariable analysis for N0 patients, LVI remained an independent predictor of OS (hazard ratio 1.804, 95% confidence interval 1.107–2.939, <i>p</i> = 0.018).</p> Conclusions <p>LVI is a significant prognostic factor for recurrence and survival in node-negative RCC, but not in node-positive disease. These results support a stage-dependent interpretation of LVI and its incorporation into postoperative surveillance and individualized risk stratification for patients with low-stage RCC.</p>

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Oncologic outcomes and prognostic significance of lymphovascular invasion in renal cell carcinoma according to nodal stage

  • 期刊论文

  • 发表日期：

    2026年4月18日

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  • Byeong Jin Kang,
  • Won Hoon Song

摘要

Purpose

To assess the prognostic significance of lymphovascular invasion (LVI) in patients with renal cell carcinoma (RCC), stratified by nodal status (N0 vs. N1), and to evaluate its influence on survival and perioperative outcomes.

Materials and Methods

A retrospective review was conducted of 2787 patients with clinical T1–2 RCC who underwent nephrectomy at a single tertiary center. Patients were categorized by LVI status and pathologic nodal stage (N0 or N1). Clinicopathological features, perioperative outcomes, and oncologic endpoints—including recurrence-free survival (RFS), disease-specific survival (DSS), and overall survival (OS)—were analyzed using Kaplan–Meier analysis and Cox proportional hazards models.

Results

Among N0 patients, LVI-positive tumors were associated with adverse preoperative markers, higher Fuhrman grades, larger tumor sizes, and poorer perioperative outcomes. These associations were not observed in N1 patients. Kaplan–Meier analysis demonstrated significantly lower RFS, DSS, and OS among patients with LVI in the N0 group (all p < 0.001), but not in the N1 group. In multivariable analysis for N0 patients, LVI remained an independent predictor of OS (hazard ratio 1.804, 95% confidence interval 1.107–2.939, p = 0.018).

Conclusions

LVI is a significant prognostic factor for recurrence and survival in node-negative RCC, but not in node-positive disease. These results support a stage-dependent interpretation of LVI and its incorporation into postoperative surveillance and individualized risk stratification for patients with low-stage RCC.