1757 USE OF PELVIC LYMPHADENECTOMY IN RADICAL CYSTECTOMY FOR BLADDER CANCER: 10-YEAR EXPERIENCE AT A SINGLE INSTITUTION

Autor: Roxelyn G. Baumgartner, Stephen F. Kappa, Daniel A. Barocas, Sam S. Chang, David F. Penson, Peter E. Clark, Michael S. Cookson, Chaochen You, Joseph A. Smith, Rodney Davis, Todd M. Morgan
Rok vydání: 2012
Předmět:
Zdroj: Journal of Urology. 187
ISSN: 1527-3792
0022-5347
DOI: 10.1016/j.juro.2012.02.1773
Popis: patients with non-metastatic muscle invasive urothelial carcinoma (UC) of the bladder treated with radical cystectomy (RC). METHODS: We retrospectively analyzed data of 1400 patients collected in two prospectively-maintained institutional databases between 2001 and 2010. Standard PLND (s-PLND) had the upper boundary at the iliac bifurcation while extended PLND (e-PLND) included the presacral and the common iliac nodes. Patients who met inclusion criteria (non-metastatic high-grade UC, not undergone neoadjuvant treatments, patients receiving e-PLND or s-PLND) were included in analysis. Univariable and multivariable Cox regression analyses was performed to identify independent predictors of DFS and CSS and, subsequently, the effect of e-PLND on DFS and CSS after stratifying according to pathological Tumor (pT) and Nodal (pN) stage was determined with a multivariable Cox analysis. RESULTS: In 971 patients who met inclusion criteria, significant predictors of DFS and CSS (p 0.05) were age, pT, pN, number of nodes removed and extent of PLND at univariable analysis and pT, pN and extent of PLND at multivariable analysis (all p 0.001). At multivariable analysis, the benefit of an e-PLND on DFS and CSS was significant across all pT stages (all p 0.05) and across all pN stages (pN 0: p 0.011 and p 0.034 for DFS and CSS, respectively; pN1 and pN2: both p 0.001). Table 1. CONCLUSIONS: The staging accuracy and the survival benefit provided by e-PLND suggest to consider this template as the standard procedure for muscle-invasive UC treated with RC.
Databáze: OpenAIRE
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