Extended versus limited lymph node dissection in radical cystectomy: impact on recurrence pattern and survival.

Objectives: To compare recurrence patterns and survival of patients with carcinoma of the urinary bladder undergoing radical cystectomy and extended or limited lymph node dissection.

Methods: From a consecutive series of 469 patients undergoing radical cystectomy, two different historical cohorts were constructed; one with 265 patients intentionally undergoing extended lymph node dissection and one with 204 patients undergoing limited lymph node dissection.

Results: Early lymph node recurrences were more frequently located outside the pelvic region in patients from the extended lymph node dissection cohort, whereas the overall risk of recurrence was not reduced by carrying out an extended lymph node dissection compared with the limited lymph node dissection cohort (8% vs 6%, P = 0.

Evaluation of different lymph node (LN) variables as prognostic markers in patients undergoing radical cystectomy and extended LN dissection to the level of the inferior mesenteric artery.

Objective: To evaluate the prognostic impact of lymph node (LN) variables in patients undergoing radical cystectomy (RC) and extended LN dissection.

Patients And Methods: From January 2004 to January 2009, 167 patients with bladder cancer underwent RC and extended LN dissection to the level of the inferior mesenteric artery in a surgery-only series with no neoadjuvant or adjuvant chemotherapy. Correlation to prognosis of different LN variables according to presence of LN metastasis, number, localization, extracapsular extension (ECE), size, volume, LN density and N-stage according to two different Tumour-Node-Metastasis (TNM) classifications were analysed.

Long-term risk of progression of carcinoma in situ of the bladder and impact of bacille Calmette-Guérin immunotherapy on the outcome.

Objective: This study aimed to determine the long-term risk of cancer progression of carcinoma in situ (CIS) of the urinary bladder, and whether intravesical bacille Calmette-Guérin (BCG) immunotherapy can reduce the risk of progression of CIS.

Material And Methods: From a prospectively enrolled cohort of bladder cancer patients treated at Ã…rhus University Hospital Skejby, Denmark, between 1994 and 2008, all 163 cases with CIS in the bladder, and a history free of invasive bladder cancer (stage T1-4) at least 1 year prior to inclusion were included in the study.

Results: Median follow-up was 51 (0-253) months for progression.

High expression of karyopherin-α2 defines poor prognosis in non-muscle-invasive bladder cancer and in patients with invasive bladder cancer undergoing radical cystectomy.

Background: Conventional clinicopathologic risk factors have failed to accurately predict the prognosis of patients with bladder cancer (BC).

Objective: To evaluate karyopherin-α2 (KPNA2) expression as a progression marker in patients with non-muscle-invasive BC (NMIBC) treated by conservative methods and as a prognostic marker in patients with invasive BC undergoing radical cystectomy (RC).

Design, Setting, And Participants: Two different tissue microarrays were constructed, one with 234 primary Ta/T1 tumours from patients treated by transurethral resection of the bladder and one with 377 tumours from RC patients.

Mini-laparotomy approach to radical cystectomy.

Objective: • To investigate the feasibility of performing radical cystectomy (RC) through a mini-laparotomy and to evaluate the effect of a smaller incision on wound problems, immediate postoperative pain, bowel function and length of hospital stay (LOS).

Patients And Methods: • Two consecutive cohorts of patients, one with 75 patients undergoing open RC (ORC) with lymph node dissection up to the aortic bifurcation through a conventional long midline incision and one with 75 patients undergoing RC through a mini-laparotomy (MinilapRC) of intentionally <8-10 cm. • Patient characteristics, operative duration, estimated blood loss (EBL), incidence and severity of wound problems, return of bowel function, amount of analgesics needed and LOS were analysed according to the intention-to-treat principle.

Size and volume of metastatic and non-metastatic lymph nodes in pelvis and lower abdomen in patients with carcinoma of the bladder undergoing radical cystectomy.

Objective: This study aimed to evaluate the usability of size and volume of lymph nodes (LNs) in the pelvis and lower abdomen to predict metastatic disease in patients with carcinoma of the urinary bladder.

Material And Methods: LNs retrieved from 177 patients undergoing radical cystectomy and extended LN dissection were prospectively registered with number, location, presence of metastatic disease, longitudinal length, transverse diameter and a calculated LN volume.

Results: A mean of 21.

Lymph node mapping in patients with bladder cancer undergoing radical cystectomy and lymph node dissection to the level of the inferior mesenteric artery.

Objective: To evaluate extended lymph node dissection (LND) as a nodal staging tool in the treatment of invasive carcinoma of the urinary bladder and to suggest a reasonable proximal limit of the dissection.

Patients And Methods: In all, 170 patients underwent radical cystectomy with extended LND up to the level of the inferior mesenteric artery. Specimens were evaluated as 13 separate packages from pre-designated anatomical locations.

Terminal patients with urinary diversion: are there specific treatment or nursing care problems in the primary healthcare sector?

Objective: To investigate the treatment and nursing care problems related to the type of urinary diversion in terminal patients experienced by the primary healthcare sector.

Methods: A questionnaire about treatment and nursing care problems related to urinary diversion was sent to general practitioners (GPs) and district nurse units (DNUs) that had been in contact with 1 of 71 patients who died following cystectomy in a 5-year period. The patients had 1 of 3 types of urinary diversion: ileal conduit (IC), Indiana pouch (IP), or Hautmann orthotopic neobladder (NB).

Chromosomal imbalance in the progression of high-risk non-muscle invasive bladder cancer.

Background: Non-muscle invasive bladder neoplasms with invasion of the lamina propria (stage T1) or high grade of dysplasia are at "high risk" of progression to life-threatening cancer. However, the individual course is difficult to predict. Chromosomal instability (CI) is associated with high tumor stage and grade, and possibly with the risk of progression.

Estimation of the true number of lymph nodes in lymphadenectomy specimens from radical cystectomy.

Objective: To evaluate the sensitivity of conventional pathological examination of lymphadenectomy specimens regarding identification of lymph nodes.

Material And Methods: Fifteen cystectomy specimens with separate package lymphadenectomy specimens from patients with invasive carcinoma of the bladder were subjected to conventional pathological examination followed by paraffin embedding and sectioning of all remaining fatty tissue. Identification of additional lymph nodes missed by the initial investigation was registered.

Sentinel lymph-node biopsy in patients with squamous cell carcinoma of the penis.

Objectives: To evaluate a single-centre experience with sentinel lymph-node biopsy (SLNB) as a staging procedure in patients with squamous cell carcinoma (SCC) of the penis.

Patients And Methods: The study included 60 patients with SCC of the penis, who had SLNB in all groins where no palpable nodes were found, and in groins with palpable nodes with negative fine-needle aspiration cytology. Lymphoscintigraphy and intraoperative lymph node detection was done using (99m)Tc-nanocolloid and no use of blue dye.

[Function of neobladders in women after cystectomy].

Introduction: Since 1999, Rigshospitalet (RH) and Aarhus University Hospital, Skejby (SKS) have been offering women an orthotopic neobladder following cystectomy. The aim of the present study was to describe the function of the neobladders in women by examining continence and voiding function. Cancer stage, cancer recurrence, complications and mortality are also described.

[Cystectomy in Denmark 2000-2005].

Introduction: The organization and results after cystectomy in Denmark are unknown.

Materials And Methods: Based upon the Danish National Hospital Register and discharge notes, postoperative hospitalization, readmission within 30 days, re-operations and mortality after cystectomy in Denmark in the period January 1, 2000-December 31, 2005 were assessed.

Results: There were 995 cystectomies with a median postoperative hospital stay of 18.

Emmprin and survivin predict response and survival following cisplatin-containing chemotherapy in patients with advanced bladder cancer.

Purpose: Cisplatin-containing chemotherapy is the standard of care for patients with locally advanced and metastatic transitional cell carcinoma of the urothelium. The response rate is approximately 50% and tumor-derived molecular prognostic markers are desirable for improved estimation of response and survival.

Experimental Design: Affymetrix GeneChip expression profiling was carried out using tumor material from 30 patients.

Gene expression signatures predict outcome in non-muscle-invasive bladder carcinoma: a multicenter validation study.

Purpose: Clinically useful molecular markers predicting the clinical course of patients diagnosed with non-muscle-invasive bladder cancer are needed to improve treatment outcome. Here, we validated four previously reported gene expression signatures for molecular diagnosis of disease stage and carcinoma in situ (CIS) and for predicting disease recurrence and progression.

Experimental Design: We analyzed tumors from 404 patients diagnosed with bladder cancer in hospitals in Denmark, Sweden, England, Spain, and France using custom microarrays.

Complications and neobladder function of the Hautmann orthotopic ileal neobladder.

Objective: To report the complications and function of the Hautmann orthotopic ileal neobladder .

Patients And Methods: In a 6.5-year period, 67 patients had an ileal neobladder constructed after radical cystectomy as treatment for invasive carcinoma of the bladder.

SOX4 expression in bladder carcinoma: clinical aspects and in vitro functional characterization.

The human transcription factor SOX4 was 5-fold up-regulated in bladder tumors compared with normal tissue based on whole-genome expression profiling of 166 clinical bladder tumor samples and 27 normal urothelium samples. Using a SOX4-specific antibody, we found that the cancer cells expressed the SOX4 protein and, thus, did an evaluation of SOX4 protein expression in 2,360 bladder tumors using a tissue microarray with clinical annotation. We found a correlation (P < 0.

Role of activating fibroblast growth factor receptor 3 mutations in the development of bladder tumors.

Purpose: Bladder tumors develop through different molecular pathways. Recent reports suggest activating mutations of the fibroblast growth factor receptor 3 (FGFR3) gene as marker for the "papillary" pathway with good prognosis, in contrast to the more malignant "carcinoma in situ" (CIS) pathway. The aim of this clinical follow-up study was to investigate the role of FGFR3 mutations in bladder cancer development in a longitudinal study.

Clinical experience with the Mentor Alpha-1 inflatable penile prosthesis: report on 65 patients.

Objective: To evaluate the complications and prosthesis survival associated with implantation of the Mentor Alpha-1 inflatable penile prosthesis (IPP) for the treatment of erectile dysfunction (ED).

Material And Methods: Between August 1995 and March 2003, 65 patients underwent implantation of a Mentor Alpha-1 IPP at the Urological Departments of Skejby or Aalborg University Hospitals. Patient data were obtained retrospectively from medical files.