The Impact of Lymphovascular Invasion on Recurrence-Free Survival in Patients with High-Risk Stage II Colorectal Cancer Treated with Adjuvant Therapy

Abstract

Objective: Lymphovascular invasion (LVI) may affect disease recurrence after operation for colorectal cancer (CRC). Whether LVI is an exact prognostic variable remains uncertain. This research aimed to investigate the relationship between clinicopathologic factors, disease-free survival (DFS), and overall survival (OS) in patients with high-risk stage II colon cancer who underwent adjuvant treatments, focusing on LVI. Materials and Methods: This study retrospectively investigated 173 patients who underwent operation for stage II tumors from September 2000 and December 2013. All patients received postoperative adjuvant therapy. The distinction among factors was calculated by a chi-square test. Survival probabilities were predicted with the Kaplan–Meier method, and group comparisons were applied with the log-rank test. Furthermore, univariate and multivariate cox regression analysis were used to determine the most substantial risk elements. Results: LVI was identified in 26 of 173 patients (15%) and was significantly related with positive perineural invasion (PNI) (p<0.001). There were no considerable differences among LVI and other clinicopathologic factors. LVI-positive patients had significantly lower DFS than LVI negative patients, with a hazard ratio of 2.83 (95% CI 1.24–6.48). The five-year survival rate of the LVI-positive group was substantially lower than for those who were LVI negative (p=0.004). Conclusion: In this research, LVI was a meaningful prognostic variable for DFS, but not for OS. This study revealed a prognostic value of LVI for DFS in patients with high-risk stage II tumor who underwent adjuvant treatments.

Keywords

• early-stage colon cancer
• disease-free survival
• lymphovascular invasion
• chemotherapy