The standard surgical treatment of invasive bladder cancer is the radical cystectomy and pelvic lymph node dissection (PLND). Up to one-third of patients with invasive bladder cancer have lymph node metastasis. Thus, PLND has important therapeutic and prognostic benefits. The number of lymph nodes that should be removed and the extent of the PLND are still a controversial issue. Recently, the trend of PLND increased toward more extended PLND. Several prognostic factors related to PLND were reported in the literature. In this paper, we will discuss the different PLND templates, number of lymph nodes that should be resected, lymph node density, lymphovascular invasion, tumor burden, extracapsular extension, and the aggregate lymph node metastasis diameter.
Early versus delayed FDG-PET/CT imaging regarding detection of lymph node metastasis in patients with invasive bladder cancer scheduled for radical cystectomy – preliminary results