To elucidate the role of vascular endothelial growth factor‐C (VEGF‐C) in bladder transitional cell carcinoma (TCC), examining VEGF‐C expression in bladder TCC tissue and the association of VEGF‐C with clinicopathological features, as the expression of VEGF‐C in several carcinomas is significantly associated with angiogenesis, lymphangiogenesis and regional lymph node metastasis, but there are few reports of VEGF‐C expression in bladder TCC.

The study included 45 patients with bladder TCC; VEGF‐C expression was assessed by immunohistochemistry and the association between VEGF‐C expression and angiogenesis, as evaluated by microvessel density (MVD), was examined.

There was VEGF‐C expression in the cytoplasm of tumour cells, but very little in the normal transitional epithelium. VEGF‐C expression was significantly associated with tumour size, pathological T stage, pathological grade, lymphatic‐venous involvement and pelvic lymph node metastasis (all P < 0.05). Multivariate analysis showed that VEGF‐C expression was an exclusive independent factor influencing pelvic lymph node metastasis. Moreover, the patients with high VEGF‐C expression had a markedly poorer prognosis than those with no or low VEGF‐C expression (P = 0.014). A multivariate analysis based on the Cox proportional hazard model showed that lymph node metastasis was only an independent prognostic factor in the multivariate analysis using the Cox regression model (P = 0.010).

The present study provides evidence supporting the involvement of VEGF‐C expression in the promotion of lymph node metastasis in bladder TCC. Examination of VEGF‐C expression in biopsy specimens might be beneficial in predicting pelvic lymph node metastasis.