Prognostic value of microvascular invasion in renal cell carcinoma

Abstract Introduction: Renal cell carcinoma (RCC) is the most common type of renal cancer. Nowadays, most tumors are discovered incidentally at an early stage, thus changing the overall prognosis of the disease. Histological prognostic factors have been accepted as major prognostic factors for decades however, the predictive value of microvascular invasion (MVI) remains debatable. We performed this study to evaluate the prognostic role of MVI in RCC. Patients and Methods: A cohort study, including 191 RCC patients undergoing laparoscopic retroperitoneal radical nephrectomy from January 2013 to April 2021 at Viet Duc University Hospita. Results: the rate of microvascular invasion was 18/191 patients (9.4%), no microvascular invasion was 90.6%. The 3-5 year RFS of the MVI – and MVI + groups were 98.76 % and 81.45 %, respectively. The 3-5-year OS of the MVI – and MVI + groups were 99.28 % and 86.27 %, respectively; difference of p < 0.05. The MVI + group had an average tumor size of 60.8 mm, which was significantly larger than the MVI – group (52.8 mm) with p=0.038. In addition, MVI + is also associated with more unfavorable pathological features such as higher sRCC (sarcomatoid RCC) rate and higher Fuhrman grade (p<0.05). Conclusion: The microvascular invasion group showed worse overall survival, and recurrence-metastasis results than the non-microvascular invasion group and was associated with more adverse factors. We suggest that MVI should be considered as an independent prognostic factor in renal cell carcinoma. Keywords: renal cell carcinoma, microvascular invasion, recurrence-free survival