Prospectively packaged lymph node dissections with radical cystectomy: evaluation of node count variability and node mapping

The Journal of Urology
Bernard H BochnerG Dalbagni

Abstract

Accumulating evidence supports the relationship between an increased number of lymph nodes (LNs) reported following radical cystectomy (RC) and overall outcome. We prospectively evaluated RC cases with transitional cell carcinoma of the bladder to determine which factors may contribute to the variability in the number of reported LNs. We conducted a prospective evaluation in which 144 patients undergoing RC and pelvic lymph node dissection (PLND) between June 2001 and April 2003 were included. Lymph nodes were processed as individual packets. A standard method of evaluating nodal submissions was used. A mixed statistical model was used with neoadjuvant chemotherapy, node status, pathological stage, bacillus Calmette-Guerin exposure, age and number of days from transurethral resection as the fixed effects. Surgeon and pathologist were treated as random effects. The extended PLND group had a significantly greater lymph node yield (median 22.5 nodes) compared to standard PLND (median 8), however, no staging advantage was observed in the extended dissection group. Only the type of PLND performed was associated with node yield (p <0.001). Subset analysis of patients with unexpected microscopic nodal involvement revealed that 33% had...Continue Reading

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Citations

Feb 14, 2012·Current Urology Reports·Robert Svatek, Pascal Zehnder
Sep 11, 2013·European Urology·Devon C Snow-LisyGeorges-Pascal Haber
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