AUA 2011 - Does the lymphatic drainage pattern of the lateral bladder wall make a bilateral pelvic lymphadenectomy (PLND) unnecessary in strictly laterally localized invasive bladder cancer? Results of a multimodality mapping study - Session Highlights

WASHINGTON, DC USA ( - An extended bilateral pelvic lymph node dissection has a measurable complication rate that can be significant in the elderly population.

For patients with clearly unilateral tumors, it would be appealing to perform a node dissection on only the affected side.

The authors evaluated 40 patients undergoing radical cystectomy with unilateral muscle invasive urothelial cancer with single photon emission computed tomography (SPECT), combined with computed tomography (CT), plus intraoperative gamma probe verification to map the primary lymphatic landing sites of the of the lateral bladder wall. These authors found that a unilateral pelvic lymph node dissection would have missed radioactive lymph nodes on the contralateral side in 40% of patients. Therefore, a bilateral extended pelvic lymph node dissection including the common iliac region up to the uretero-iliac crossing is mandatory even in strictly laterally localized bladder tumors. The authors did not detect any radioactive lymph nodes in the contralateral internal iliac region. Therefore, contralateral pelvic node dissection may be limited to the obturator fossa, external iliac and common iliac region.



Presented by Beat Roth, et al. at the American Urological Association (AUA) Annual Meeting - May 14 - 19, 2011 - Walter E. Washington Convention Center, Washington, DC USA

Reported for UroToday by David P. Wood Jr., MD, Professor, Department of Urology, University of Michigan Health System.


The opinions expressed in this article are those of the Contributing Editor and do not necessarily reflect the viewpoints of the American Urological Association.



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