Lymphovascular invasion as a prognostic tool for advanced bladder cancer

Purpose of review Lymphovascular invasion has been correlated with the metastatic ability of the cancer. It has been studied in urological tumours at every location, but it has only been included as a prognostic factor in the TNM (tumour, lymph nodes and metastasis) classification of germ cell testicular tumours. The purpose of this evaluation is to look into the predictive value of lymphovascular invasion in locally advanced bladder cancer. Recent findings Studies carried out in patients who underwent cystectomy report a lymphovascular invasion incidence of 30-50% of the cases. All of them agree that there is a correlation between the presence of lymphovascular invasion and disease evolution, but some authors consider that only blood vessel invasion is a statistically significant independent prognostic factor, and others find that this happens only in lymph node-negative cases. Summary All papers stress the prognostic value of lymphovascular invasion, most of them as an independent factor, but there are still some doubts as to its use in clinical decision making, owing to the poor diagnosis reproducibility. This is why it would be necessary to reach a consensus on strict diagnostic criteria as soon as possible to be able to incorporate this prognostic factor in clinical practice.