NSU-MD Faculty Articles

The role of radical cystectomy and pelvic lymphadenectomy in node positive bladder cancer- The MSKCC experience

Publication Title

Cancer

Publisher

John Wiley & Sons, Inc.

ISSN

0008-543X

Publication Date

6-15-1994

Keywords

Combined Modality Therapy, Female, Humans, Lymph Node Excision, Lymph Nodes, Male, Pelvis, Prognosis, Regression Analysis, Survival Rate, Urinary Bladder, Urinary Bladder Neoplasms

Abstract

BACKGROUND: The impact of pelvic lymph node dissection (PLND) on the survival of patients with lymph node positive bladder cancer is controversial.

METHODS: The authors retrospectively analyzed the long term and disease free survival among 140 patients with lymph node positive disease having radical cystectomy and bilateral PLND at the Memorial Sloan-Kettering Cancer Center between 1980 and 1988. They also sought to identify prognostic variables for recurrence and survival.

RESULTS: Of the 140 patients, 36 (25.7%) were found to be tumor free, with 22 (15.7%) followed longer than 5 years. Regression analysis identified P-category as the only prognostic parameter influencing survival. Patients with tumors confined to the bladder (< or = P3a) had a 52.6% 5-year survival rate compared with 23.4% among those with extravesical (> or = P3b) tumors. N-category was a significant predictor for recurrence but not survival.

CONCLUSIONS: As judged from this analysis, radical cystectomy and a systematic PLND alone can provide favorable outcome in some patients with regional nodal metastases from bladder cancer. The survival advantage is most pronounced in patients with low stage primary tumors. Stage migration and patient selection may have biased these findings.

Volume

73

Issue

12

First Page

3020

Last Page

3028

Disciplines

Medicine and Health Sciences

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