Lymphovascular invasion affects prognosis of colorectal cancer liver metastasis underwent primary resection: a propensity score matching analysis
Abstract Background Lymphovascular invasion (LVI) is associated with poor prognosis in a variety of malignancies; however, its prognostic value has not been fully defined in patients with colorectal cancer with liver metastases (CRCLM). The aim of this study was to investigate the impact of LVI on l...
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2025-04-01
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| Series: | BMC Cancer |
| Online Access: | https://doi.org/10.1186/s12885-025-14083-2 |
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| author | Wei Li Bo Liu Xingxing Xiang Qun Zhang Qinglin Yang Yinghao Cao Tao Liu |
| author_facet | Wei Li Bo Liu Xingxing Xiang Qun Zhang Qinglin Yang Yinghao Cao Tao Liu |
| author_sort | Wei Li |
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| description | Abstract Background Lymphovascular invasion (LVI) is associated with poor prognosis in a variety of malignancies; however, its prognostic value has not been fully defined in patients with colorectal cancer with liver metastases (CRCLM). The aim of this study was to investigate the impact of LVI on long-term postoperative recurrence and survival in patients with CRCLM. Methods Clinicopathologic data were retrospectively collected from patients who underwent primary resection for CRCLM at Wuhan Union Hospital from 2013 to 2018. To reduce potential confounders and selection bias, we used propensity score matching (PSM) to compare the clinicopathologic characteristics and long-term prognostic outcomes of patients in the LVI (+) and LVI (-) groups. Cox unifactorial and multifactorial analyses were used to screen relevant factors affecting patient prognosis, and Kaplan-Meier curves were plotted to compare differences in patient overall survival (OS) and disease-free survival (DFS). The predictive power of independent factors on patients’ long-term prognosis was assessed using receiver operating characteristic ROC) curves and area under the curve (AUC). Results After PSM, 230 patients were enrolled in the study (n = 115 per group). Multifactorial analysis revealed that LVI was an independent prognostic factor for OS and DFS (hazard ratio [HR], 1.424; 95% confidence interval [CI], 1.004–2.022; P = 0.048 and HR, 1.452; 95% CI, 1.020–2.069; p = 0.039, respectively). In the LVI (-) group, postoperative chemotherapy did not significantly improve OS or DFS; however, in the LVI (+) group, those who received chemotherapy had significantly improved OS (HR: 1.593, 95% CI: 1.187 − 2.571; P = 0.044) and DFS (HR: 1.503, 95% CI. 1.033 − 2.422; P = 0.045) compared with patients not treated with chemotherapy. In the LVI (+) group, the AUC for the OS AUROC curves was more favorable compared with after PSM (AUC at 3 years: 0.786 vs. 0.903; AUC at 5 years: 0.744 vs. 0.889). For DFS, the area under the AUROC curve was also better in the LVI (+) subgroup compared with after PSM (AUC at 3 years: 0.825 vs. 0.874; AUC at 5 years: 0.839 vs. 0.863). Conclusions LVI may significantly impact long-term survival and prognosis in patients with CRCLM undergoing primary resection, potentially serving as an independent prognostic factor for OS and DFS. Additionally, postoperative chemotherapy appears to significantly improve the long-term prognosis of patients with LVI (+). |
| format | Article |
| id | doaj-art-4d4e140b09ae4da0a4a95a703fb161eb |
| institution | Kabale University |
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| language | English |
| publishDate | 2025-04-01 |
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| spelling | doaj-art-4d4e140b09ae4da0a4a95a703fb161eb2025-08-20T03:52:24ZengBMCBMC Cancer1471-24072025-04-0125111710.1186/s12885-025-14083-2Lymphovascular invasion affects prognosis of colorectal cancer liver metastasis underwent primary resection: a propensity score matching analysisWei Li0Bo Liu1Xingxing Xiang2Qun Zhang3Qinglin Yang4Yinghao Cao5Tao Liu6Department of Digestive Surgical Oncology, Union Hospital, Tongji Medical College, Huazhong University of Science and TechnologyDepartment of Gastrointestinal Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and TechnologyDepartment of Digestive Surgical Oncology, Union Hospital, Tongji Medical College, Huazhong University of Science and TechnologyDepartment of Digestive Surgical Oncology, Union Hospital, Tongji Medical College, Huazhong University of Science and TechnologyDepartment of Digestive Surgical Oncology, Union Hospital, Tongji Medical College, Huazhong University of Science and TechnologyDepartment of Digestive Surgical Oncology, Union Hospital, Tongji Medical College, Huazhong University of Science and TechnologyDepartment of Digestive Surgical Oncology, Union Hospital, Tongji Medical College, Huazhong University of Science and TechnologyAbstract Background Lymphovascular invasion (LVI) is associated with poor prognosis in a variety of malignancies; however, its prognostic value has not been fully defined in patients with colorectal cancer with liver metastases (CRCLM). The aim of this study was to investigate the impact of LVI on long-term postoperative recurrence and survival in patients with CRCLM. Methods Clinicopathologic data were retrospectively collected from patients who underwent primary resection for CRCLM at Wuhan Union Hospital from 2013 to 2018. To reduce potential confounders and selection bias, we used propensity score matching (PSM) to compare the clinicopathologic characteristics and long-term prognostic outcomes of patients in the LVI (+) and LVI (-) groups. Cox unifactorial and multifactorial analyses were used to screen relevant factors affecting patient prognosis, and Kaplan-Meier curves were plotted to compare differences in patient overall survival (OS) and disease-free survival (DFS). The predictive power of independent factors on patients’ long-term prognosis was assessed using receiver operating characteristic ROC) curves and area under the curve (AUC). Results After PSM, 230 patients were enrolled in the study (n = 115 per group). Multifactorial analysis revealed that LVI was an independent prognostic factor for OS and DFS (hazard ratio [HR], 1.424; 95% confidence interval [CI], 1.004–2.022; P = 0.048 and HR, 1.452; 95% CI, 1.020–2.069; p = 0.039, respectively). In the LVI (-) group, postoperative chemotherapy did not significantly improve OS or DFS; however, in the LVI (+) group, those who received chemotherapy had significantly improved OS (HR: 1.593, 95% CI: 1.187 − 2.571; P = 0.044) and DFS (HR: 1.503, 95% CI. 1.033 − 2.422; P = 0.045) compared with patients not treated with chemotherapy. In the LVI (+) group, the AUC for the OS AUROC curves was more favorable compared with after PSM (AUC at 3 years: 0.786 vs. 0.903; AUC at 5 years: 0.744 vs. 0.889). For DFS, the area under the AUROC curve was also better in the LVI (+) subgroup compared with after PSM (AUC at 3 years: 0.825 vs. 0.874; AUC at 5 years: 0.839 vs. 0.863). Conclusions LVI may significantly impact long-term survival and prognosis in patients with CRCLM undergoing primary resection, potentially serving as an independent prognostic factor for OS and DFS. Additionally, postoperative chemotherapy appears to significantly improve the long-term prognosis of patients with LVI (+).https://doi.org/10.1186/s12885-025-14083-2 |
| spellingShingle | Wei Li Bo Liu Xingxing Xiang Qun Zhang Qinglin Yang Yinghao Cao Tao Liu Lymphovascular invasion affects prognosis of colorectal cancer liver metastasis underwent primary resection: a propensity score matching analysis BMC Cancer |
| title | Lymphovascular invasion affects prognosis of colorectal cancer liver metastasis underwent primary resection: a propensity score matching analysis |
| title_full | Lymphovascular invasion affects prognosis of colorectal cancer liver metastasis underwent primary resection: a propensity score matching analysis |
| title_fullStr | Lymphovascular invasion affects prognosis of colorectal cancer liver metastasis underwent primary resection: a propensity score matching analysis |
| title_full_unstemmed | Lymphovascular invasion affects prognosis of colorectal cancer liver metastasis underwent primary resection: a propensity score matching analysis |
| title_short | Lymphovascular invasion affects prognosis of colorectal cancer liver metastasis underwent primary resection: a propensity score matching analysis |
| title_sort | lymphovascular invasion affects prognosis of colorectal cancer liver metastasis underwent primary resection a propensity score matching analysis |
| url | https://doi.org/10.1186/s12885-025-14083-2 |
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