Significance of lymphovascular invasion and lymph node involvement: Impact on survival after adjuvant chemotherapy in locally advanced bladder cancer

2005 ◽  
Vol 23 (16_suppl) ◽  
pp. 4774-4774
Author(s):  
C. Song ◽  
J.-H. Ahn ◽  
H. Ahn
Keyword(s):  
Bladder Cancer ◽  
Lymph Node ◽  
Adjuvant Chemotherapy ◽  
Lymphovascular Invasion ◽  
Locally Advanced ◽  
Lymph Node Involvement ◽  
Advanced Bladder Cancer ◽  
Impact On Survival ◽  
Node Involvement

Cancer-specific mortality following radical cystectomy for bladder cancer with lymph node involvement: impact of pathologic disease features and adjuvant chemotherapy

2014 ◽  
Vol 33 (3) ◽  
pp. 373-379 ◽  
Author(s):  
Marisa M. Clifton ◽  
Sarah P. Psutka ◽  
Stephen A. Boorjian ◽  
John C. Cheville ◽  
Prabin Thapa ◽  
...  
Keyword(s):  
Bladder Cancer ◽  
Lymph Node ◽  
Adjuvant Chemotherapy ◽  
Radical Cystectomy ◽  
Lymph Node Involvement ◽  
Specific Mortality ◽  
Node Involvement ◽  
Cancer Specific Mortality

scholarly journals Extranodal Extension Predicts Poor Survival Outcomes among Patients with Bladder Cancer

Cancers ◽  
2021 ◽  
Vol 13 (16) ◽  
pp. 4108
Author(s):  
Yi-An Liao ◽  
Chun-Ju Chiang ◽  
Wen-Chung Lee ◽  
Bo-Zhi Zhuang ◽  
Chung-Hsin Chen ◽  
...  
Keyword(s):  
Bladder Cancer ◽  
Lymph Node ◽  
Adjuvant Chemotherapy ◽  
Cancer Patients ◽  
Radical Cystectomy ◽  
Lymph Node Involvement ◽  
Survival Outcomes ◽  
Nodal Disease ◽  
Extranodal Extension ◽  
Node Involvement

Background: Several lymph node-related prognosticators were reported in bladder cancer patients with lymph node involvement and receiving radical cystectomy. However, extranodal extension (ENE) remained a debate to predict outcomes. Methods: A retrospective analysis of 1303 bladder cancer patients receiving radical cystectomy and bilateral pelvic lymph node dissection were identified in the National Taiwan Cancer Registry database from 2011 to 2017. Based on the 304 patients with lymph node involvement, the presence of ENE and major clinical information were recorded and calculated. The overall survival (OS) and cancer-specific survival (CSS) were estimated with Kaplan–Meier analysis and compared using the log-rank test. Hazard ratios (HR) and the associated 95% confidence intervals were calculated in the univariate and stepwise multivariable models. Results: In the multivariable analysis, ENE significantly reduced OS (HR = 1.74, 95% CI 1.09–2.78) and CSS (HR = 1.69, 95% CI 1.01–2.83) more than non-ENE. In contrast, adjuvant chemotherapy was significantly associated with better OS and CSS upon the identification of pathological nodal disease. Conclusions: Reduced OS and CSS outcomes were observed in the pathological nodal bladder cancer patients with ENE compared with those without ENE. After the identification of pathological nodal disease, adjuvant chemotherapy was associated with better survival outcomes.

320: Clinical Relevance of Lymph Node Status and Adjuvant Chemotherapy in Locally Advanced Bladder Cancer

2004 ◽  
Vol 171 (4S) ◽  
pp. 84-84
Author(s):  
Dieter R. Echtle ◽  
Elizabeth M. Mueller ◽  
Detlef H. Frohneberg
Keyword(s):  
Bladder Cancer ◽  
Lymph Node ◽  
Adjuvant Chemotherapy ◽  
Clinical Relevance ◽  
Locally Advanced ◽  
Lymph Node Status ◽  
Node Status ◽  
Advanced Bladder Cancer

Evaluating the prognostic significance of lymphovascular invasion in stage II and III colon cancer.

2019 ◽  
Vol 37 (4_suppl) ◽  
pp. 685-685 ◽  
Author(s):  
Dorotea Mutabdzic ◽  
Shalana BL O'Brien ◽  
Elizabeth A. Handorf ◽  
Karthik Devarajan ◽  
Sanjay S. Reddy ◽  
...  
Keyword(s):  
Colon Cancer ◽  
Overall Survival ◽  
Lymph Node ◽  
High Risk ◽  
Adjuvant Chemotherapy ◽  
Lymphovascular Invasion ◽  
Lymph Node Involvement ◽  
Stage Ii ◽  
Stage Iii ◽  
Node Involvement

685 Background: Presence of lymphovascular invasion (LVI) is known to be a predictor of lymph node involvement in colon adenocarcinoma (CA). Lymph node involvement is associated with poorer prognosis necessitating adjuvant therapy. While some studies have suggested that LVI is a predictor of worse overall survival in early stage colon cancer, the significance of LVI on prognosis has not been tested in a comprehensive North American data set. Methods: Patients with stage II and III CA with LVI data available and those who received predefined standard of care treatment were identified from the National Cancer Data Base (NCDB) from 2011 to 2015. The relationship between LVI and overall survival was tested using Kaplan-Meier survival curves and Cox proportional hazards regression analysis after adjusting for relevant clinical and demographic variables. Hazard ratios and 95% confidence intervals are reported along with median overall survival (OS) where available. Results: The dataset included 93,070 patients with stage II and 66,701 patients with stage III CA. The proportion of patients with LVI was 13% in stage II and 47% in stage III CA. After adjusting for age, sex, gender, race, comorbidities, socioeconomic status, T, and N stage, LVI was associated with worse OS in stage II, HR 1.2 (1.15-1.25, p < 0.001), and in stage III, HR 1.25 (1.21-1.30, p < 0.001), CA. Median OS was 6.51 years with LVI versus. 6.85 years without LVI in stage II compared with 6.57 years with LVI versus not reached without LVI in stage III CA. Of the stage II patients with LVI, 20% received adjuvant chemotherapy (CT) and median OS was 6.91 years for those who did versus 6.07 years for those who did not receive CT. Conclusions: Our data suggest that LVI is an important predictor of OS in stage II and III CA. There is evidence that adjuvant chemotherapy improves OS in advanced CA but there remains uncertainty as to the benefit in stage II. Despite this uncertainty, guidelines suggest consideration of adjuvant CT in patients with high-risk stage II disease. Our data support the recommendation that LVI be considered a high-risk feature in stage II disease. Further studies are necessary to examine whether the type or duration of CT should differ for patients with CA and LVI.

scholarly journals Benefit of adjuvant chemotherapy based on lymph node involvement for oesophageal cancer following trimodality therapy

ESMO Open ◽  
2018 ◽  
Vol 3 (5) ◽  
pp. e000386 ◽  
Author(s):  
Christopher Nevala-Plagemann ◽  
Samual Francis ◽  
Courtney Cavalieri ◽  
Randa Tao ◽  
Jonathan Whisenant ◽  
...  
Keyword(s):  
Lymph Node ◽  
Adjuvant Chemotherapy ◽  
Oesophageal Cancer ◽  
Locally Advanced ◽  
Survival Rates ◽  
Lymph Node Involvement ◽  
Trimodality Therapy ◽  
Risk Of Death ◽  
Node Involvement ◽  
Reduced Risk

BackgroundOesophageal cancer (OC) survival rates have improved since the widespread adoption of neoadjuvant chemoradiation therapy (NACRT) followed by oesophagectomy (trimodality therapy). Unfortunately, the overall prognosis for patients with locally advanced disease remains poor. In this study, we sought to assess the effect of adjuvant chemotherapy (AC) in patients treated with trimodality therapy.MethodsUsing the National Cancer Database we retrospectively identified 6785 patients with locally advanced (cT1b-T4a, N0-N+, M0) OC who were treated with trimodality therapy from 2006 to 2014. Patients were separated based on receipt of AC (n=463), as well as clinical and pathological lymph node involvement. Overall survival (OS) between groups was compared using the Kaplan-Meier method and Cox proportional hazard modelling.ResultsBased on multivariate analysis, AC was associated with a statistically significantly reduced risk of death (HR 0.77, p<0.001). Subgroup analysis revealed that AC was associated with reduced risk of death compared with NACRT alone in the cN+/pN0 (median OS 64 vs 43 months; p=0.019) and the cN+/pN+ (median OS 27 vs 22 months; p=0.010) groups, but not in the cN0/pN0 (median OS 48 vs 49 months; p=0.253) or cN0/pN+ (median OS 31 vs 24 months; p=0.077) groups.ConclusionAC following trimodality therapy may improve survival in patients with locally advanced OC. Patients who undergo lymph node downstaging may be the most likely to benefit from AC. Prospective studies are needed to confirm this finding.

scholarly journals Comparative Effectiveness of Treatment Strategies for Bladder Cancer With Clinical Evidence of Regional Lymph Node Involvement

2016 ◽  
Vol 34 (22) ◽  
pp. 2627-2635 ◽  
Author(s):  
Matthew D. Galsky ◽  
Kristian Stensland ◽  
John P. Sfakianos ◽  
Reza Mehrazin ◽  
Michael Diefenbach ◽  
...  
Keyword(s):  
Bladder Cancer ◽  
Lymph Node ◽  
Adjuvant Chemotherapy ◽  
Preoperative Chemotherapy ◽  
Comparative Effectiveness ◽  
Combined Modality Therapy ◽  
Treatment Strategies ◽  
Distant Metastases ◽  
Lymph Node Involvement ◽  
Node Involvement

Purpose Patients with bladder cancer with clinical lymph node involvement (cN+) are at high risk for distant metastases, but are potentially curable. Such patients are excluded from neoadjuvant chemotherapy trials and pooled with patients with distant metastases in first-line chemotherapy trials not suited to define the role of combined-modality therapy. To address this evidence void, we performed a comparative effectiveness analysis. Methods We included cTanyN1-3M0 bladder cancer patients from the National Cancer Data Base (2003-2012) treated with chemotherapy and/or cystectomy. We used multistate survival analysis, allowing for delayed entry, to assess overall survival (OS) according to various treatment strategies. Effectiveness was estimated with multivariable adjustment for tumor-, patient-, and facility-level characteristics. Results Among 1,739 patients (cN1, 48%; cN2, 45%; cN3, 7%), 1,104 underwent cystectomy and 635 were treated with chemotherapy alone. Of the cystectomy patients, 363 received preoperative and 328 received adjuvant chemotherapy. The crude 5-year OS for chemotherapy alone, cystectomy alone, preoperative chemotherapy followed by cystectomy, and cystectomy followed by adjuvant chemotherapy was 14% (95% CI, 11% to 17%), 19% (95% CI, 15% to 24%), 31% (95% CI, 25% to 38%), and 26% (95% CI, 21% to 34%), respectively. Compared with cystectomy alone, preoperative chemotherapy was associated with a significant improvement in OS (hazard ratio, 0.80; 95% CI, 0.66 to 0.97). Adjuvant chemotherapy was also associated with a significant improvement in survival compared with cystectomy alone. The survival of patients treated with chemotherapy alone was worse than those treated with cystectomy alone. Conclusion A subset of patients with cN+ bladder cancer achieves long-term survival. Combined-modality therapy, with chemotherapy and cystectomy, is associated with the best outcomes.

396 CANCER-SPECIFIC MORTALITY FOLLOWING RADICAL CYSTECTOMY FOR BLADDER CANCER WITH LYMPH NODE INVOLVEMENT: IMPACT OF DISEASE FEATURES AND ADJUVANT CHEMOTHERAPY

2013 ◽  
Vol 189 (4S) ◽  
Author(s):  
Marisa Clifton ◽  
Stephen Boorjian ◽  
John Cheville ◽  
Robert Tarrell ◽  
Prabin Thapa ◽  
...  
Keyword(s):  
Bladder Cancer ◽  
Lymph Node ◽  
Adjuvant Chemotherapy ◽  
Radical Cystectomy ◽  
Lymph Node Involvement ◽  
Specific Mortality ◽  
Node Involvement ◽  
Cancer Specific Mortality

Prognostic implications of lymph node involvement in bladder cancer: are we understaging using current methods?

2011 ◽  
Vol 108 (4) ◽  
pp. 484-492 ◽  
Author(s):  
Kara L. Watts ◽  
Benjamin T. Ristau ◽  
Harold T. Yamase ◽  
John A. Taylor III
Keyword(s):  
Bladder Cancer ◽  
Lymph Node ◽  
Lymph Node Involvement ◽  
Node Involvement ◽  
Prognostic Implications

scholarly journals Serum cyfra21-1 associated with biological aggressiveness and poor prognosis in male patients with urothelial carcinoma of bladder.

2020 ◽  
Author(s):  
Haitao Liang ◽  
Yunlin Ye ◽  
Zhu Lin ◽  
Zikun Ma ◽  
Lei Tan ◽  
...  
Keyword(s):  
Overall Survival ◽  
Lymph Node ◽  
Lymphovascular Invasion ◽  
Disease Free Survival ◽  
Lymph Node Involvement ◽  
Free Survival ◽  
Node Involvement ◽  
Male Patients ◽  
Disease Free ◽  
Urothelial Carcinoma Of Bladder

Abstract Background : To assess the prognostic value of preoperative serum cyfra21-1 in male patients with urothelial carcinoma of bladder treated with radical cystectomy.Methods: Patients underwent radical cystectomy from 2009-2018 at our center were retrospectively analyzed and 267 male patients met our criterions. The median follow-up was 34 months. The serum level of cyfra21-1 was measured using enzyme linked immunosorbent assay. Patients were divided into two groups (cyfra21-1≤3.30ng/ml and cyfra21-1>3.30 ng/ml). Clinical significance of cyfra21-1 level was assessed.Results: Of the 267 patients, 110 (41.2%) had normal cyfra21-1, while 157 (58.8%) had elevated serum cyfra21-1. The prevalence of lymph node involvement, locally advanced stage (≥ pT3), tumor stages, tumor size and papillary were significantly higher in patients with elevated cyfra21-1 than in those with normal cyfra21-1. Patients with high cyfra21-1 showed worse Disease free survival and Overall survival than those with low cyfra21-1 ( P = 0.001 and 0.007, respectively). In multivariate analysis, High cyfra21-1, lymph node involvement, lymphovascular invasion and papillary were independent predictors of worse Disease free survival ( P = 0.036, <0.001, 0.002, 0.014 respectively). High cyfra21-1, lymph node involvement and lymphovascular invasion were also confirmed as independent predictors of worse Overall survival ( P = 0.038, 0.010, 0.005, respectively.)Conclusions: Elevated cyfra21-1 was associated with greater biological aggressiveness and worse prognosis than normal cyfra21-1.

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