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The following is a summary of “Lymphovascular invasion is an independent predictor of metastasis and disease-specific death in cutaneous squamous cell carcinoma: a multicenter retrospective study,” published in the April 2025 issue of Journal of the American Academy of Dermatology by Hirotsu et al. 

Lymphovascular invasion (LVI) was recognized as a high-risk characteristic of cutaneous squamous cell carcinoma (CSCC) but was not included in existing CSCC staging systems.  

Researchers conducted a retrospective study to determine whether LVI served as an independent predictor of major adverse outcomes in CSCC.  

They gathered data from 12 centers contributing to an international CSCC database and collected information on clinical characteristics, pathological risk factors, treatments, and outcomes. The CSCC cases were classified according to LVI status and identified tumors that developed major poor outcomes, including nodal metastasis, in-transit metastasis, distant metastasis, and disease-specific death (defined as [nodal metastasis, in-transit metastasis, distant metastasis, and disease-specific death]).  

The results showed that among 23,166 CSCCs, 179 tumors (0.8%) were positive for LVI+. At 3 years, LVI+ tumors had a higher cumulative incidence of major poor outcomes compared to LVI− tumors (33.5% vs 3.2%) [33.5% vs 3.2% at 3 years; overall cumulative incidence function P < 0.001]. In adjusted analysis, LVI+ tumors showed a 1.82-fold increase in the risk of major poor outcomes (subdistribution hazard ratio [SHR] = 1.82; P = 0.002) [SHR = 1.82; P = 0.002]. Among BWH low-stage tumors (T1 or T2a), LVI+ cases had a higher 3-year incidence of major poor outcomes compared to LVI− tumors (20.7% vs 1.61%) [20.7% vs 1.61% at 3 years, overall cumulative incidence function P < 0.001].  

Investigators concluded that the presence of LVI in CSCC was a significant high-risk factor and an independent predictor of both metastasis and disease-specific mortality across all tumor stages. 

Source: jaad.org/article/S0190-9622(25)00623-1/abstract