SynthesisDigestive endoscopy : official journal of the Japan Gastroenterological Endoscopy Society2024
Additional staining for lymphovascular invasion is associated with increased estimation of lymph node metastasis in patients with T1 colorectal cancer: Systematic review and meta-analysis.
Synthesis in Digestive endoscopy : official journal of the Japan Gastroenterological Endoscopy Society, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.
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Who cites it
9 citing papers in PubMed, 10 citations in OpenAlex.
- Young age or surgical selection? Interpreting lymph-node metastasis risk in T1 colorectal cancer.Journal of gastroenterology · 2026Article
- Prognostic significance of lymphovascular invasion in colorectal mucinous adenocarcinoma after curative resection: a nationwide multi-center retrospective cohort study.Journal of gastrointestinal oncology · 2026Article
- T1 colorectal cancer: determinants of lymph node metastasis, survival patterns, and risk-adapted management.Updates in surgery · 2026Review
- Reimagining Nodal Staging in Colorectal Cancer: Toward a Novel Non-Invasive Imaging Approach.Cancers · 2026Review
- Interobserver variability of histopathological assessment in pT1 colorectal carcinoma.Histopathology · 2026Article
- Potential factors of false-negative sentinel lymph node biopsy for breast cancer and clinical decision-making value of axillary lymph node dissection.BMC surgery · 2025Article
- Improving radiologists' diagnostic accuracy for lymphovascular invasion in colorectal cancer: insights from a multicenter CT-based study.Abdominal radiology (New York) · 2025Article
- LVI-PathNet: Segmentation-classification pipeline for detection of lymphovascular invasion in whole slide images of lung adenocarcinoma.Journal of pathology informatics · 2024Article
- Combination of single-source dual-energy computed tomography (CT) parameters and extracellular volume fraction for predicting lymphovascular and perineural invasion in colorectal cancer.Quantitative imaging in medicine and surgery · 2024Article
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Authors and funding
12 authors at 7 institutions in 2 countries.
Funding
Abstract
objectivesLymphovascular invasion (LVI) is a critical risk factor for lymph node metastasis (LNM), which requires additional surgery after endoscopic resection of T1 colorectal cancer (CRC). However, the impact of additional staining on estimating LNM is unclear. This systematic review aimed to evaluate the impact of additional staining on determining LNM in T1 CRC.
methodsWe searched five electronic databases. Outcomes were diagnostic odds ratio (DOR), assessed using hierarchical summary receiver operating characteristic curves, and interobserver agreement among pathologists for positive LVI, assessed using Kappa coefficients (κ). We performed a subgroup analysis of studies that simultaneously included a multivariable analysis for other risk factors (deep submucosal invasion, poor differentiation, and tumor budding).
resultsAmong the 64 studies (18,097 patients) identified, hematoxylin-eosin (HE) and additional staining for LVI had pooled sensitivities of 0.45 (95% confidence interval [CI] 0.32-0.58) and 0.68 (95% CI 0.44-0.86), specificities of 0.88 (95% CI 0.78-0.94) and 0.76 (95% CI 0.62-0.86), and DORs of 6.26 (95% CI 3.73-10.53) and 6.47 (95% CI 3.40-12.32) for determining LNM, respectively. In multivariable analysis, the DOR of additional staining for LNM (DOR 5.95; 95% CI 2.87-12.33) was higher than that of HE staining (DOR 1.89; 95% CI 1.13-3.16) (P = 0.01). Pooled κ values were 0.37 (95% CI 0.22-0.52) and 0.62 (95% CI 0.04-0.99) for HE and additional staining for LVI, respectively.
conclusionAdditional staining for LVI may increase the DOR for LNM and interobserver agreement for positive LVI among pathologists.
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