Survival and clinicopathological significance of blood vessel invasion in operable breast cancer: a systematic review and meta-analysis. (24th September 2022)

• Record Type: Journal Article
• Authors: Lin, Yingxin; Zhang, Yuehua; Fang, Huiqiong; Hu, Qian; Duan, Haibo; Zhang, Liangyun; Pang, Danmei
• Is Part Of: Japanese journal of clinical oncology. Volume 53:Number 1(2023)
• Page Start: 35
• Page End: 45
• Publication Date: 2022-09-24
• Subjects: blood vessel invasion -- breast cancer -- clinicopathological significance -- meta-analysis -- prognosis; Oncology -- Periodicals; Cancer -- Periodicals; 616.994005
• DOI: 10.1093/jjco/hyac149
• Languages: English
• ISSNs: 0368-2811

Abstract

Abstract: Background: Lymphovascular invasion, including lymphatic-vessel invasion and blood-vessel invasion, plays an important role in distant metastases. The metastatic pattern of blood-vessel invasion may differ from that of lymphatic-vessel invasion. However, its prognostic significance in breast cancer remains controversial. We evaluated the role of blood-vessel invasion in the prognosis of operable breast-cancer patients and its association with clinicopathological characteristics. Methods: We systematically searched EMBASE, PubMed, the Cochrane Library and Web of Science for studies in English through December 2020. Disease-free survival, overall survival and cancer-specific survival were the primary outcomes. Pooled hazard ratios and 95% confidence intervals were assessed using a random-effects model. Results: Twenty-seven studies involving 7954 patients were included. Blood-vessel invasion occurred in 20.4% of tumor samples. Pooled results showed significant associations of blood-vessel invasion with worse disease-free survival (hazard ratio = 1.82; 95% confidence interval = 1.43–2.31) and overall survival (hazard ratio = 1.86; 95% confidence interval = 1.16–2.99) in multivariate analyses. The results of the univariate analyses were similar. Among the clinicopathological factors, blood-vessel invasion was associated with larger tumor size, lymph-node metastasis, nonspecific invasive type, higher histological grade, estrogen receptor-negative breast cancer, human epidermal growth factor receptor 2-positive breast cancer and lymphatic-vessel invasion. In the lymph-node-negative subgroup analyses, the presence of blood-vessel invasion led to poorer disease-free survival (hazard ratio = 2.46; 95%confidence interval = 1.64–3.70) and overall survival (hazard ratio = 2.94; 95%confidence interval = 1.80–4.80). Conclusions: We concluded that blood-vessel invasion is an independent predictor of poor prognosis in operable breast cancer and is associated with aggressive clinicopathological features. Breast-cancer patients with blood-vessel invasion require more aggressive treatments after surgery. Abstract : Blood-vessel invasion was an independent predictor of poor prognosis in operable breast cancer and was associated with aggressive clinicopathological features. Breast-cancer patients with blood-vessel invasion require more aggressive treatment postoperatively.