PURPOSE: To assess the impact of the number of lymph nodes removed and of the template of dissection during radical cystectomy for bladder cancer on patients' survival rates. MATERIALS AND METHODS: We evaluated 282 consecutive patients who underwent radical cystectomy for muscle-invasive or high-grade superficial bladder cancer between 1995 and 2011. Exclusion criteria were incomplete follow-up data and neo-adjuvant or adjuvant treatments. Patients were divided into groups according to the most informative cut-point of number of lymph nodes retrieved and of the template of dissection. The cancer-specific survival rates were estimated by the Kaplan-Meier method. The univariate and multivariable forward-stepwise Cox proportional hazards regression were applied to analyze the survival outcomes. RESULTS: The mean (SD) follow-up was 59.2 ± 44.3 months, and the mean (SD) age of the entire cohort population was 68.3 ± 8.3 years. The cancer-specific survival rates were 58.7 and 47.7 % at 5 and 10 years, respectively. Considering both node-positive and node-negative patients, those with at least 14 LNs removed and those submitted to extended or super-extended PLND experienced significantly higher cancer-specific survival at both univariate and multivariable analysis. CONCLUSIONS: Patients undergoing a more extended pelvic lymph node dissection, both in terms of number of LN removed and in terms of template of dissection, will experience a better cancer-specific survival. Our data support a potential role of lymphadenectomy on cancer outcome.
PURPOSE: To assess the impact of the number of lymph nodes removed and of the template of dissection during radical cystectomy for bladder cancer on patients' survival rates. MATERIALS AND METHODS: We evaluated 282 consecutive patients who underwent radical cystectomy for muscle-invasive or high-grade superficial bladder cancer between 1995 and 2011. Exclusion criteria were incomplete follow-up data and neo-adjuvant or adjuvant treatments. Patients were divided into groups according to the most informative cut-point of number of lymph nodes retrieved and of the template of dissection. The cancer-specific survival rates were estimated by the Kaplan-Meier method. The univariate and multivariable forward-stepwise Cox proportional hazards regression were applied to analyze the survival outcomes. RESULTS: The mean (SD) follow-up was 59.2 ± 44.3 months, and the mean (SD) age of the entire cohort population was 68.3 ± 8.3 years. The cancer-specific survival rates were 58.7 and 47.7 % at 5 and 10 years, respectively. Considering both node-positive and node-negative patients, those with at least 14 LNs removed and those submitted to extended or super-extended PLND experienced significantly higher cancer-specific survival at both univariate and multivariable analysis. CONCLUSIONS:Patients undergoing a more extended pelvic lymph node dissection, both in terms of number of LN removed and in terms of template of dissection, will experience a better cancer-specific survival. Our data support a potential role of lymphadenectomy on cancer outcome.
Authors: Ryan P Dorin; Siamak Daneshmand; Manuel S Eisenberg; Shahin Chandrasoma; Jie Cai; Gus Miranda; Peter W Nichols; Donald G Skinner; Eila C Skinner Journal: Eur Urol Date: 2011-07-14 Impact factor: 20.096
Authors: Tobias Maurer; Michael Souvatzoglou; Hubert Kübler; Katharina Opercan; Stefan Schmidt; Ken Herrmann; Jens Stollfuss; Gregor Weirich; Bernhard Haller; Jürgen E Gschwend; Markus Schwaiger; Bernd J Krause; Uwe Treiber Journal: Eur Urol Date: 2011-12-14 Impact factor: 20.096
Authors: M May; C Protzel; M W Vetterlein; M Gierth; J Noldus; A Karl; T Grimm; B Wullich; M O Grimm; P Nuhn; P J Bastian; J Roigas; B Hadaschik; C Gilfrich; M Burger; M Fisch; S Brookman-May; A Aziz; O W Hakenberg Journal: Int Urol Nephrol Date: 2016-11-28 Impact factor: 2.370