Prognostic Significance of Lymphatic Vessel Invasion and Density in Colorectal Carcinoma: A Systematic Review and Meta-analysis.

[BACKGROUND/AIM] This systematic review and meta-analysis evaluated the relationship between lymphatic vessel invasion (LVI) and lymphatic vessel density (LVD) - with specific focus on distinguishing peritumoral from intratumoral LVD, assessed by immunohistochemistry - and survival outcomes in patients with colorectal carcinoma (CRC).

[MATERIALS AND METHODS] Following Cochrane Handbook and PRISMA guidelines, we included original studies evaluating tumor LVD and/or LVI in colorectal cancer using immunohistochemistry and reporting hazard ratios for overall survival (OS) and/or disease/recurrence-free survival (DFS). Data from MEDLINE, Cochrane Library, and PubMed (past 25 years) were extracted, analyzed with Stata, and assessed for heterogeneity and publication bias.

[RESULTS] The principal results of the present study were the statistically significant correlations between a) LVI and reduced OS (0.003), b) high peritumoral LVD and longer DFS (0.044) and c) high LVD (total) and reduced OS (0.001). However, no statistically significant correlation was found between peritumoral or intratumoral LVD and OS.

[CONCLUSION] LVI and LVD parameters (peritumoral, intratumoral, total), evaluated using immunohistochemistry, may provide valuable information with respect to the prognosis of patients with CRC.