Predictors of adequate lymph node dissection in patients with non–muscle invasive bladder cancer undergoing radical cystectomy and effect on survival

Radical cystectomy with pelvic lymphadenectomy represents the gold standard for treatment of muscle-invasive bladder cancer. Extent of the lymph node dissection and lymph node involvement during radical cystectomy are the most powerful prognostic factors associated with poor oncological outcome. However, the optimal boundaries of the lymph node dissection during a radical cystectomy are controversial. The published literature based mostly on retrospective studies suggests that increasing the number of nodes excised may have therapeutic and diagnostic benefits without significantly increasing the surgical morbidity. These conclusions are, however, influenced by selection and surgeon biases, inconsistencies in the quality of the surgery, and node count variability. In this paper, we establish the current understanding about the utility of lymphadenectomy during a radical cystectomy for muscle-invasive bladder cancer.

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The role of neoadjuvant chemotherapy, lymph node dissection, and treatment delay in patients with muscle-invasive bladder cancer undergoing partial cystectomy

Urologic Oncology Seminars and Original Investigations ◽

10.1016/j.urolonc.2021.01.016 ◽

2021 ◽

Author(s):

Andrew T. Lenis ◽

Katherine E. Fero ◽

Leslie Ojeaburu ◽

Patrick M. Lec ◽

Vishnukamal Golla ◽

...

Keyword(s):

Bladder Cancer ◽

Lymph Node ◽

Neoadjuvant Chemotherapy ◽

Lymph Node Dissection ◽

Treatment Delay ◽

Invasive Bladder Cancer ◽

Node Dissection ◽

Muscle Invasive Bladder Cancer ◽

Muscle Invasive

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Should patients with muscle-invasive bladder cancer undergo more-extensive pelvic lymph node dissection?

Nature Clinical Practice Urology ◽

10.1038/ncpuro1198 ◽

2008 ◽

Vol 5 (10) ◽

pp. 528-529 ◽

Cited By ~ 1

Author(s):

Kenneth E Steven

Keyword(s):

Bladder Cancer ◽

Lymph Node ◽

Lymph Node Dissection ◽

Pelvic Lymph Node Dissection ◽

Pelvic Lymph Node ◽

Invasive Bladder Cancer ◽

Node Dissection ◽

Muscle Invasive Bladder Cancer ◽

Muscle Invasive

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Importance of Node Dissection in Relation to Neoadjuvant and Adjuvant Therapy

Journal of the National Comprehensive Cancer Network ◽

10.6004/jnccn.2006.0085 ◽

2006 ◽

Vol 4 (10) ◽

pp. 1019-1026 ◽

Cited By ~ 1

Author(s):

William C. Huang ◽

Bernard H. Bochner

Keyword(s):

Bladder Cancer ◽

Lymph Node ◽

Lymph Node Dissection ◽

Pelvic Lymph Node Dissection ◽

Pelvic Lymph Node ◽

Invasive Bladder Cancer ◽

Node Dissection ◽

Muscle Invasive Bladder Cancer ◽

Quality Of Surgery ◽

Muscle Invasive

Since the advent of effective chemotherapeutic regimens for treating transitional cell carcinoma, multimodal therapy has become part of the contemporary management of patients with muscle-invasive bladder cancer. However, radical cystectomy with pelvic lymphadenectomy remains the cornerstone of treatment for patients with localized and regionally advanced muscle-invasive disease. The effectiveness of chemotherapy models in bladder cancer can depend greatly on the quality of surgery. Unfortunately, without sufficient level I data, the boundaries of lymphadenectomy and the diagnostic and therapeutic ramifications of variations in the pelvic lymph node dissection remain undetermined. This article examines the role of pelvic lymph node dissection during perioperative chemotherapy and discusses the current challenges in establishing standards for lymphadenectomy in patients undergoing treatment for muscle-invasive bladder cancer.

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Effect of delayed radical cystectomy for invasive bladder tumors on lymph node positivity, cancer-specific survival and total survival

Tumori Journal ◽

10.5301/tj.5000626 ◽

2018 ◽

Vol 104 (6) ◽

pp. 434-437

Author(s):

Hakan Türk ◽

Sıtkı Ün ◽

Ahmet Cinkaya ◽

Hilmi Kodaz ◽

Murtaza Parvizi ◽

...

Keyword(s):

Overall Survival ◽

Bladder Cancer ◽

Lymph Node ◽

Radical Cystectomy ◽

Transitional Cell ◽

Invasive Bladder Cancer ◽

Lymph Node Status ◽

Muscle Invasive Bladder Cancer ◽

Cancer Specific Survival ◽

Muscle Invasive

Introduction: Radical cystectomy (RC) is the main treatment option for patients with muscle-invasive bladder cancer (MIBC) and non-muscle-invasive bladder cancer (NMIBC), which carry the highest risk of progression. In this study, we investigated the effect of time from transurethral resection of the bladder (TUR-B) to cystectomy on lymph node positivity, cancer-specific survival and overall survival in patients with MIBC. Methods: The records were reviewed of 530 consecutive patients who had RC and pelvic lymphadenectomy procedures with curative intent performed by selected surgeons between May 2005 and April 2016. Our analysis included only patients with transitional cell carcinoma of the bladder; we excluded 23 patients with other types of tumor histology. Results: Patients who underwent delayed RC were compared with patients who were treated with early RC; both groups were similar in terms of age, gender, T stage, tumor grade, tumor differentiation, lymph node status and metastasis status. However, when both groups were compared for disease-free survival and overall survival, patients of the early-RC group had a greater advantage. Conclusions: The optimal time between the last TUR-B and RC is still controversial. A reasonable time for preoperative preparation can be allowed, but long delays, especially those exceeding 3 months, can lead to unfavorable outcomes in cancer control.

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