ArticleJournal of gastrointestinal oncology2026
Prognostic significance of lymphovascular invasion in colorectal mucinous adenocarcinoma after curative resection: a nationwide multi-center retrospective cohort study.
Article in Journal of gastrointestinal oncology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Colorectal mucinous adenocarcinoma (MAC) shows heterogeneous outcomes after curative resection, and the prognostic value of lymphovascular invasion (LVI) remains unclear. This study evaluated the association of LVI with clinicopathological features, overall survival (OS), and disease-free survival (DFS) in patients with colorectal MAC. Methods: This retrospective cohort study included 2,391 adults with stage I-III pathologically confirmed colorectal MAC who underwent curative resection across 21 hospitals in China between 2016 and 2021. Patients were excluded if they had a mucinous component <50%, age <18 or >80 years, multiple primary tumors, synchronous multiple colorectal cancers, stage IV disease, or incomplete clinical, pathological, or follow-up data. Baseline clinicopathological factors included sex, age, tumor size, tumor location, differentiation, LVI status, T category, N category, and tumor-node-metastasis (TNM) stage. LVI was defined as tumor cells within endothelial-lined spaces or destruction of a lymphovascular wall. Postoperative surveillance was performed every 3 months for 2 years and every 6 months thereafter up to 5 years. OS and DFS were obtained from follow-up records and analyzed using Kaplan-Meier, log-rank, and Cox proportional hazards methods. LVI was fixed as the primary exposure in multivariable Cox models, and collinearity among candidate covariates was assessed using the variance inflation factor (VIF). All statistical tests were two-sided. Results: Among 2,391 patients, 1,397 (58.4%) were male, 994 (41.6%) were female, and 1,231 (51.5%) had stage III disease. LVI was detected in 541 patients (22.6%). LVI positivity was significantly associated with poor differentiation, advanced T stage, N stage, and TNM stage (all P<0.001). The 3-year OS rate was lower in the LVI-positive group than in the LVI-negative group (74.2% Conclusions: In patients with MAC after curative resection, LVI was associated with more advanced pathological features and independently predicted poorer OS and DFS. Routine assessment of LVI may improve postoperative risk stratification and help identify patients who require closer surveillance.
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