Harry W Herr1. 1. Department of Urology, Memorial Sloan-Kettering Cancer Center, New York, New York 10021, USA. herrh@mskcc.org
Abstract
PURPOSE: The concept of lymph node density (ratio of positive-to-total number of nodes examined) is reviewed as a prognostic factor for recurrence-free survival after cystectomy in patients with invasive bladder cancer. MATERIALS AND METHODS: The literature was queried for all articles that directly or indirectly address lymph node density (nodal ratios) and survival of bladder cancer. RESULTS: Five studies on a total of 979 patients were found. In 4 studies lymph node density was a significant predictive factor for survival when adjusted for patient, tumor and treatment covariates. CONCLUSIONS: Considerable data support the use of lymph node density in bladder cancer prognosis. A methodological evaluation of the prognostic importance of nodal ratios in large multicenter data sets and validation in a prospective clinical trial are merited before lymph node density is accepted into routine clinical practice.
PURPOSE: The concept of lymph node density (ratio of positive-to-total number of nodes examined) is reviewed as a prognostic factor for recurrence-free survival after cystectomy in patients with invasive bladder cancer. MATERIALS AND METHODS: The literature was queried for all articles that directly or indirectly address lymph node density (nodal ratios) and survival of bladder cancer. RESULTS: Five studies on a total of 979 patients were found. In 4 studies lymph node density was a significant predictive factor for survival when adjusted for patient, tumor and treatment covariates. CONCLUSIONS: Considerable data support the use of lymph node density in bladder cancer prognosis. A methodological evaluation of the prognostic importance of nodal ratios in large multicenter data sets and validation in a prospective clinical trial are merited before lymph node density is accepted into routine clinical practice.
Authors: S G Patel; M Amit; T C Yen; C T Liao; P Chaturvedi; J P Agarwal; L P Kowalski; A Ebrahimi; J R Clark; C R Cernea; S J Brandao; M Kreppel; J Zöller; D Fliss; E Fridman; G Bachar; T Shpitzer; V A Bolzoni; P R Patel; S Jonnalagadda; K T Robbins; J P Shah; Z Gil Journal: Br J Cancer Date: 2013-09-24 Impact factor: 7.640