Abstract
Purpose
Lymphatic vascular invasion (LVI) is a poor prognostic factor for hypopharyngeal squamous cell carcinoma (HPSCC), but the risk factors of LVI and its relationship with clinicopathological of HPSCC remain unclear. This study aims to explore these issues.
Methods
We retrospectively analyzed the clinicopathological data of 170 patients with HPSCC from January 2011 to December 2015. The relationship between LVI and clinicopathologic was analyzed by Chi-square test or Fisher’s exact test. The risk factors of LVI were examined using a logistic regression model, while risk factors of survival rate were carried out using the Cox regression model.
Results
LVI occurred in 59 cases (34.7%). In multivariate analysis, T3–4 stage (HR = 2.877; 95% CI: 1.379–6.004; p = 0.005), N2–3 stage (HR = 2.325; 95% CI: 1.120–4.824; p = 0.024), and poor differentiation (HR = 2.983; 95% CI: 1.229–7.242; p = 0.016) were independent risk factors for LVI; positive LVI was an independent risk factor for local recurrence (HR = 2.488; 95% CI: 1.150–5.383; p = 0.021), poor 5-year OS (HR = 0.375; 95% CI: 0.232–0.606; p < 0.000), DSS (HR = 0.374; 95% CI: 0.235–0.595; p < 0.000), and DFS (HR = 0.454; 95% CI:0.254–0.813; p = 0.008).
Conclusion
T3–4 stage, N2–3 stage and poor differentiation are independent risk factors for LVI of HPSCC; LVI increases the local recurrence and regional recurrence rate, and decreases 5-year OS, DFS and DSS of HPSCC.
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Data availability
The data that support the findings of this study are available from the corresponding author upon reasonable request.
References
Garneau JC, Bakst RL, Miles BA (2018) Hypopharyngeal cancer: a state of the art review. Oral Oncol 86:244–250. https://doi.org/10.1016/j.oraloncology.2018.09.025
Huang PW, Lin CY, Hsieh CH, Hsu CL, Fan KH, Huang SF et al (2018) A phase II randomized trial comparing neoadjuvant chemotherapy followed by concurrent chemoradiotherapy versus concurrent chemoradiotherapy alone in advanced squamous cell carcinoma of the pharynx or larynx. Biomed J 41(2):129–136. https://doi.org/10.1016/j.bj.2018.04.003
Wagner K, Abraham E, Tran B, Roshan D, Wykes J, Campbell P et al (2020) Lymphovascular invasion and risk of recurrence in papillary thyroid carcinoma. ANZ J Surg 90(9):1727–1732. https://doi.org/10.1111/ans.16202
Zhang S, Zhang D, Gong M, Wen L, Liao C, Zou L (2017) High lymphatic vessel density and presence of lymphovascular invasion both predict poor prognosis in breast cancer. BMC Cancer 17(1):335. https://doi.org/10.1186/s12885-017-3338-x
Lo WC, Wu CT, Wang CP, Yang TL, Lou PJ, Ko JY et al (2017) Lymph node ratio predicts recurrence and survival for patients with resectable stage 4 Hypopharyngeal cancer. Ann Surg Oncol 24(6):1707–1713. https://doi.org/10.1245/s10434-017-5770-1
Saito Y, Omura G, Yasuhara K, Rikitake R, Akashi K, Fukuoka O et al (2017) Prognostic value of lymphovascular invasion of the primary tumor in hypopharyngeal carcinoma after total laryngopharyngectomy. Head Neck 39(8):1535–1543. https://doi.org/10.1002/hed.24705
Heng Y, Zhu X, Zhou L, Zhang M, Zhou H, Tao L (2020) The presence of risk factors and corresponding treatment strategies post-surgical resection in stage IV hypopharyngeal squamous cell carcinoma patients: a retrospective cohort study. Ann Transl Med. 8(5):189. https://doi.org/10.21037/atm.2020.01.102
Kim SY, Rho YS, Choi EC, Kim MS, Woo JH, Lee DH et al (2017) Clinicopathological factors influencing the outcomes of surgical treatment in patients with T4a hypopharyngeal cancer. BMC Cancer 17(1):904. https://doi.org/10.1186/s12885-017-3880-6
Lin H, Wang T, Heng Y, Zhu X, Zhou L, Zhang M et al (2020) Risk stratification of postoperative recurrence in hypopharyngeal squamous-cell carcinoma patients with nodal metastasis. J Cancer Res Clin Oncol 14(3):803–811. https://doi.org/10.1007/s00432-020-03337-0
Bu Z, Zheng Z, Li Z, Zhang L, Wu A, Wu X et al (2013) Lymphatic vascular invasion is an independent correlated factor for lymph node metastasis and the prognosis of resectable T2 gastric cancer patients. Tumour Biol 34(2):1005–1012. https://doi.org/10.1007/s13277-012-0637-3
Adel M, Kao HK, Hsu CL, Huang JJ, Lee LY, Huang Y et al (2015) Evaluation of lymphatic and vascular invasion in relation to clinicopathological factors and treatment outcome in oral cavity squamous cell carcinoma. Medicine (Baltimore) 94(43):e1510. https://doi.org/10.1097/MD.0000000000001510
Norhisham NF, Chong CY, Safuan S (2015) Peritumoral lymphatic vessel density and invasion detected with immunohistochemical marker D240 is strongly associated with distant metastasis in breast carcinoma. BMC Clin Pathol 17:2. https://doi.org/10.1186/s12907-017-0041-4
Chu Y, Mao T, Li X, Jing X, Ren M, Huang Z et al (2020) Predictors of lymph node metastasis and differences between pure and mixed histologic types of early gastric signet-ring cell carcinomas. Am J Surg Pathol 44(7):934–942. https://doi.org/10.1097/PAS.0000000000001460
Chen TC, Wang CP, Ko JY, Yang TL, Hsu CW, Yeh KA et al (2013) The impact of perineural invasion and/or lymphovascular invasion on the survival of early-stage oral squamous cell carcinoma patients. Ann Surg Oncol 20(7):2388–2395. https://doi.org/10.1245/s10434-013-2870-4
Zhang CD, Ning FL, Zeng XT, Dai DQ (2018) Lymphovascular invasion as a predictor for lymph node metastasis and a prognostic factor in gastric cancer patients under 70 years of age: a retrospective analysis. Int J Surg 53:214–220. https://doi.org/10.1016/j.ijsu.2018.03.073
Chirila M, Bolboaca SD, Muresan M, Tomescu E, Cosgarea M (2011) Lymphatic and vascular invasion in laryngeal and pyriform sinus carcinomas. Laryngorhinootologie 90(6):358–363. https://doi.org/10.1055/s-0031-1271758
Takeshi T, Toru S, Hiroki M et al (2018) Salvage surgery for local recurrence of hypopharyngeal squamous cell carcinoma after definitive radiotherapy or chemoradiotherapy or bioradiotherapy. J Japan Soc Head Neck Surg 27(3):277–283. https://doi.org/10.5106/jjshns.27.277
Rodrigues J, Breda E, Monteiro E (2018) Surgically-treated locoregionally advanced hypopharyngeal cancer: outcomes. Int Arch Otorhinolaryngol 22(4):443–448. https://doi.org/10.1055/s-0038-1641562
Perry C, Soomro I, Kaye P, Hardy E, Parsons SL, Ragunath K et al (2015) Analysis of lymphatic and blood vessel invasion biomarkers in T1 esophagogastric adenocarcinomas for improved patient prognostication. Dis Esophagus 28(3):262–268. https://doi.org/10.1111/dote.12190
Voelker HU, Scheich M, Nowack I, Metzger A, Haubitz I, Puppe B et al (2009) Lymphangiosis carcinomatosa in squamous cell carcinomas of larynx and hypopharynx—value of conventional evaluation and additional immunohistochemical staining of D2–40. World J Surg Oncol 7:25. https://doi.org/10.1186/1477-7819-7-25
Voelker HU, Hintermeier I, Strehl A, Scheich M (2020) Prognostic potential of the expression of podoplanin (D2–40) within cells of squamous cell carcinoma of the larynx and hypopharynx. World J Oncol 11(2):65–71. https://doi.org/10.14740/wjon1259
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Clinical Research Plan of SHDC( Grant NO. 16CR2029B).
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DP: conceptualization, methodology, writing—review and editing; GG: methodology, formal analysis, data curation, writing—original draft preparation, visualization; CXW: writing—review and editing, supervision; CLX, ZY, ZC: data curation.
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Since this is a retrospective study, no approval of the Research Ethics Committee was carried out, but it has been registered in the Shanghai General Hospital of Nanjing Medical University.
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Gang, G., Xinwei, C., LiXiao, C. et al. Risk factors of lymphovascular invasion in hypopharyngeal squamous cell carcinoma and its influence on prognosis. Eur Arch Otorhinolaryngol 279, 1473–1479 (2022). https://doi.org/10.1007/s00405-021-06906-2
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DOI: https://doi.org/10.1007/s00405-021-06906-2