Prognostic significance of lymphovascular invasion in colorectal mucinous adenocarcinoma after curative resection: a nationwide multi-center retrospective cohort study.

Authors

Tianhao Wang, Bin Ren, Haoqing He, Peng Zhang, Changqing Jing, Xu Guan, Yueming Sun, Yifei Zhang, Shanglei Ning, Minhao Yu, Yanfeng Lv, Lei Wang, Meng Jiao, Yanlai Sun, Qi Sun, Dongning Liu, Xianghai Ren, Zhibin Ye, Zhao Zhang, Jun Li, Bin Ma, Guodong Yu, Wei Fu, Guangyong Zhang, Hui Yang

Published in

Journal of gastrointestinal oncology. Volume 17. Issue 4. Pages 234. Aug 31, 2026. Epub Jul 08, 2026.

Abstract

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.
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.
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% vs. 86.5%, P<0.001), as was the 3-year DFS rate (73.8% vs. 86.3%, P<0.001). In fixed-LVI multivariable Cox models, LVI positivity remained independently associated with poorer OS [hazard ratio (HR) =1.855; 95% confidence interval (CI): 1.319-2.607, P<0.001] and DFS (HR =1.923; 95% CI: 1.366-2.706, P<0.001). Subgroup analyses showed that LVI-positive patients had poorer OS and DFS than LVI-negative patients in left-sided colon, rectum, T3 stage, lymph node metastasis, and TNM stage III subgroups.
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.

PMID:
42703285
Bibliographic data and abstract were imported from PubMed on 07 Sep 2026.

Read full publication at:
Please sign in to see all details.

Stats

1-terrible, 9-excellent. How would you rate this publication? Sign in in to submit your rating.

Post a comment

You need to be signed in to post comments. You can sign in here.

Comments

There are no comments yet.