Prognostic Significance of Lymphatic Vessel Invasion and Density in Colorectal Carcinoma: A Systematic Review and Meta-analysis

Background/Aim: This systematic review and meta-analysis evaluated the relationship between lymphatic vessel invasion (LVI) and lymphatic vessel density (LVD) - with specific focus on distinguishing peritumoral from intratumoral LVD, assessed by immunohistochemistry - and survival outcomes in patients with colorectal carcinoma (CRC). Materials and Methods: Following Cochrane Handbook and PRISMA guidelines, we included original studies evaluating tumor LVD and/or LVI in colorectal cancer using immunohistochemistry and reporting hazard ratios for overall survival (OS) and/or disease/recurrence-free survival (DFS). Data from MEDLINE, Cochrane Library, and PubMed (past 25 years) were extracted, analyzed with Stata, and assessed for heterogeneity and publication bias. Results: The principal results of the present study were the statistically significant correlations between a) LVI and reduced OS (p=0.003), b) high peritumoral LVD and longer DFS (p=0.044) and c) high LVD (total) and reduced OS (p