PURPOSE: To assess the impact of the number of lymph nodes removed and of the template of dissection during radical cystectomy for bladder cancer on patients' survival rates.
MATERIALS AND METHODS: We evaluated 282 consecutive patients who underwent radical cystectomy for muscle-invasive or high-grade superficial bladder cancer between 1995 and 2011. Exclusion criteria were incomplete follow-up data and neo-adjuvant or adjuvant treatments. Patients were divided into groups according to the most informative cut-point of number of lymph nodes retrieved and of the template of dissection. The cancer-specific survival rates were estimated by the Kaplan-Meier method. The univariate and multivariable forward-stepwise Cox proportional hazards regression were applied to analyze the survival outcomes.
RESULTS: The mean (SD) follow-up was 59.2 ± 44.3 months, and the mean (SD) age of the entire cohort population was 68.3 ± 8.3 years. The cancer-specific survival rates were 58.7 and 47.7 % at 5 and 10 years, respectively. Considering both node-positive and node-negative patients, those with at least 14 LNs removed and those submitted to extended or super-extended PLND experienced significantly higher cancer-specific survival at both univariate and multivariable analysis.
CONCLUSIONS: Patients undergoing a more extended pelvic lymph node dissection, both in terms of number of LN removed and in terms of template of dissection, will experience a better cancer-specific survival. Our data support a potential role of lymphadenectomy on cancer outcome.
Written by:
Brunocilla E, Pernetti R, Schiavina R, Borghesi M, Vagnoni V, Rocca GC, Borgatti F, Concetti S, Martorana G. Are you the author?
Department of Urology, University of Bologna, S. Orsola-Malpighi Hospital, Palagi 9 Street, 40134, Bologna, Italy.
Reference: Int Urol Nephrol. 2013 May 12. Epub ahead of print.
doi: 10.1007/s11255-013-0461-8
PubMed Abstract
PMID: 23666588
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