Background: Controversy exists regarding the optimal extent of lymphadenectomy and the number of lymph nodes to be retrieved at radical cystectomy (RC).
Objective: To compare the disease-free survival of patients with standard lymphadenectomy (endopelvic region composed of the internal, external iliac, and obturator groups of lymph nodes) versus extended lymphadenectomy (up to the level of origin of the inferior mesenteric artery) at RC in a prospective cohort of patients at a single, high-volume center.
Design, Setting, And Participants: Prospective data were collected from 400 consecutive patients treated with RC for bladder cancer by two high-volume surgeons at Mansoura Urology and Nephrology Center. Of the 400 patients, 200 (50%) received extended lymphadenectomy and the other 200 (50%) underwent standard lymphadenectomy at RC. The patients did not receive any neoadjuvant or adjuvant therapy.
Measurements: Patient characteristics and outcomes are evaluated.
Results And Limitations: Median patient age for the entire group was 53.0 yr. Ninety-six patients (24.0%) had lymph node metastases. Median follow-up was 50.2 mo. Estimates of 5-yr disease-free survival in the extended lymphadenectomy group were 66.6% compared with 54.7% for patients with standard lymphadenectomy (p = 0.043). Extended lymphadenectomy was associated with better disease-free survival after adjusting for the effects of standard pathologic features (p = 0.02). When restricting the analyses to lymph node-positive patients, patients with extended lymphadenectomy had much better 5-yr disease-free survival compared with patients with standard lymphadenectomy (48.0% vs 28.2%; p = 0.029). The study was nonrandomized.
Conclusions: Extended lymphadenectomy is associated with better disease-free survival for bladder cancer patients with endopelvic lymph node involvement and should be considered in these patients.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1016/j.eururo.2011.05.062 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Long-term follow-up of combination therapy with pembrolizumab and anlotinib in thoracic SMARCA4-deficient undifferentiated tumor: a case report and molecular features.
Front Oncol
December 2024
Cancer Center, Department of Pathology, Zhejiang Provincial People's Hospital(Affiliated People's Hospital), Hangzhou Medical College, Hangzhou, China.
Thoracic SMARCA4-deficient undifferentiated tumors (SMARCA4-UTs), recently recognized as a rare malignancy described in the 5th edition of the World Health Organization Classification of Tumors, are characterized by an inactivating mutation in SMARCA4, most commonly found in the mediastinum of male smokers. Despite the aggressive nature and poor prognosis associated with these tumors, which have a median survival time of approximately 4-7 months, no standardized treatment guidelines are currently established. There are currently no reported cases of extended progression-free survival (PFS) in SMARCA4-UT patients treated with surgery and immunotherapy.
View Article and Find Full Text PDF[Clinical Study of Lymph Node Dissection in Robot-Assisted Radical Prostatectomy for High-Risk Prostate Cancer].
Hinyokika Kiyo
November 2024
The Department of Urology, Kyoto University Hospital.
We retrospectively analyzed the regions and perioperative outcomes associated with lymph node dissection in patients with prostate cancer. Of 543 patients who underwent robot-assisted radical prostatectomy for prostate cancer with or without lymph node dissection according to the modified D'Amico criteria, 333 (61.3%), 128 (23.
View Article and Find Full Text PDFEvaluating the efficacy of the endoscopic thyroidectomy via sternocleidomastoid muscle posteroinferior approach in identifying occult lateral cervical lymph node metastasis.
Gland Surg
November 2024
Department of Thyroid Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Beijing, China.
Background: Lateral cervical lymph node metastasis (LLNM) is a well-established prognostic factor influencing recurrence and survival in patients with papillary thyroid carcinoma (PTC). However, the accuracy of preoperative imaging examinations is limited. We have pioneered a minimally invasive technique-endoscopic thyroidectomy via sternocleidomastoid muscle posteroinferior approach (ETSPIA).
View Article and Find Full Text PDFRefractory Chylous Ascites Leading to Chylothorax Following Extended Right Hepatectomy for Intrahepatic Cholangiocarcinoma.
Cureus
November 2024
Department of Thoracic Surgery, Tenri Hospital, Tenri, JPN.
Chylous ascites, a rare but severe complication of abdominal surgery, often results from lymphatic vessel damage during procedures, such as extended resection and lymphadenectomy. Although conservative management through dietary modifications and medications is the primary approach, refractory cases may lead to severe complications including nutritional deficiencies and even death. Herein, we report a case of refractory chylous ascites that progressed to chylothorax after extended right hepatectomy with lymph node dissection for intrahepatic cholangiocarcinoma.
View Article and Find Full Text PDFUnusual Extension of Superficial Spreading Squamous Cell Carcinoma of Cervix to Uterus, Paraovarian, Paratubal Tissue, and Vaginal Surface: A Unique Case Report.
J Midlife Health
October 2024
Department of Obstetrics and Gynecology, All India Institute of Medical Sciences, Bibinagar, Telangana, India.
Superficial spreading cervical squamous cell carcinoma (SCC) is a rare phenomenon with few cases reported in the literature. The present case report briefs the findings of superficial spreading cervical SCC in postmenopausal women. A 65-year-old postmenopausal woman presented with bleeding per-vaginum for 1-2 months.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!