OBJECTIVES: According to current guidelines, radical cystectomy (RC) should be combined with an extended pelvic lymphadenectomy (PLND) as therapeutic and staging instrument. Objective of this study was to analyze the influence of PLND on survival rates and complication rates in a selected group of elderly patients with a minimum age of 80 years. MATERIALS AND METHODS: In this single-center retrospective analysis, we evaluated 102 patients who underwent RC due to UCB from 2004 to 2015 at our institution. In 74 patients (73%), RC was combined with PLND; in 28 cases (27%), RC was performed without PLND. Impact of PLND on cancer specific survival (CSS), overall survival (OS) and progression-free survival (PFS) was analyzed using log-rank test and COX regression model. RESULTS: In univariate analysis of the data, we were not able to show a significant impact of PLND on CSS (p = 0.606), OS (p = 0.979) or PFS (p = 0.883). Also in multivariate analysis of the data, we were not able to identify PLND as an independent prognostic parameter on survival rates of patients undergoing RC, neither for CSS (p = 0.912) nor OS (p = 0.618) or PFS (p = 0.900). CONCLUSIONS: Our small and single-center study was not able to demonstrate a significant independent influence of PLND on CSS, OS and PFS in octogenarians undergoing RC due to UCB. There is no doubt that RC should usually be combined with PLND, but the results of this small data set with a selected patient cohort indicate that RC without PLND might be an option in selected cases of elderly patients.
OBJECTIVES: According to current guidelines, radical cystectomy (RC) should be combined with an extended pelvic lymphadenectomy (PLND) as therapeutic and staging instrument. Objective of this study was to analyze the influence of PLND on survival rates and complication rates in a selected group of elderly patients with a minimum age of 80 years. MATERIALS AND METHODS: In this single-center retrospective analysis, we evaluated 102 patients who underwent RC due to UCB from 2004 to 2015 at our institution. In 74 patients (73%), RC was combined with PLND; in 28 cases (27%), RC was performed without PLND. Impact of PLND on cancer specific survival (CSS), overall survival (OS) and progression-free survival (PFS) was analyzed using log-rank test and COX regression model. RESULTS: In univariate analysis of the data, we were not able to show a significant impact of PLND on CSS (p = 0.606), OS (p = 0.979) or PFS (p = 0.883). Also in multivariate analysis of the data, we were not able to identify PLND as an independent prognostic parameter on survival rates of patients undergoing RC, neither for CSS (p = 0.912) nor OS (p = 0.618) or PFS (p = 0.900). CONCLUSIONS: Our small and single-center study was not able to demonstrate a significant independent influence of PLND on CSS, OS and PFS in octogenarians undergoing RC due to UCB. There is no doubt that RC should usually be combined with PLND, but the results of this small data set with a selected patient cohort indicate that RC without PLND might be an option in selected cases of elderly patients.
Authors: A Karl; A Buchner; A Becker; M Staehler; M Seitz; W Khoder; B Schneevoigt; E Weninger; P Rittler; T Grimm; C Gratzke; C Stief Journal: J Urol Date: 2013-08-19 Impact factor: 7.450
Authors: Ruben De Groote; Giorgio Gandaglia; Nicolas Geurts; Marijn Goossens; Elisabeth Pauwels; Frederiek D'Hondt; Christian Gratzke; Nicola Fossati; Geert De Naeyer; Peter Schatteman; Paul Carpentier; Giacomo Novara; Alexandre Mottrie Journal: J Endourol Date: 2016-06-06 Impact factor: 2.942
Authors: Evi Comploj; Jeremy West; Michael Mian; Luis Alex Kluth; Alexander Karl; Christopher Dechet; Shahrokh F Shariat; Christian G Stief; Emanuela Trenti; Salvatore Palermo; Michele Lodde; Wolfgang Horninger; Stephan Madersbacher; Armin Pycha Journal: Urol Int Date: 2014-06-24 Impact factor: 2.089
Authors: Stefan Tritschler; Clarissa Mosler; Julia Straub; Alexander Buchner; Alexander Karl; Anno Graser; Christian Stief; Derya Tilki Journal: World J Urol Date: 2011-12-25 Impact factor: 4.226
Authors: J Alfred Witjes; Thierry Lebret; Eva M Compérat; Nigel C Cowan; Maria De Santis; Harman Maxim Bruins; Virginia Hernández; Estefania Linares Espinós; James Dunn; Mathieu Rouanne; Yann Neuzillet; Erik Veskimäe; Antoine G van der Heijden; Georgios Gakis; Maria J Ribal Journal: Eur Urol Date: 2016-06-30 Impact factor: 20.096
Authors: Alexander Karl; Peter R Carroll; Jürgen E Gschwend; Ruth Knüchel; Francesco Montorsi; Christian G Stief; Urs E Studer Journal: Eur Urol Date: 2009-01-13 Impact factor: 20.096
Authors: J Alfred Witjes; Eva Compérat; Nigel C Cowan; Maria De Santis; Georgios Gakis; Thierry Lebret; Maria J Ribal; Antoine G Van der Heijden; Amir Sherif Journal: Eur Urol Date: 2013-12-12 Impact factor: 20.096
Authors: Eu Chang Hwang; Niranjan J Sathianathen; Mari Imamura; Gretchen M Kuntz; Michael C Risk; Philipp Dahm Journal: Cochrane Database Syst Rev Date: 2019-05-14