Introduction: Lymph node dissection during radical cystectomy or nephroureterectomy confers improved prognosis and eventually therapeutic advantage. The aim of this update is to clarify the anatomical limits of the lymph node dissection, imaging related techniques, possible difficulties related to pathological analysis, its prognostic value and adjuvant treatments.
Method: A literature review was performed using PubMed database with a combination of the following keywords: "urothelial carcinoma", "lymph node excision", "imaging", "pathology analysis", "prognosis", "chemotherapy" and "radiotherapy".
Results: Regarding bladder tumours, extended lymph node dissection is usually performed up to the division of the iliac vessels and the crossing of the ureters. The CT scan is the recommended imaging technique for lymph node staging but its sensitivity is low. Pathological examination should include perivesicle lymph nodes analysis and report the number of normal and metastatic lymph nodes separately. The prognosis is correlated to the total number of lymph nodes removed and to the extent of the excision. The lymph node density (number of metastatic nodes/normal nodes) is the most important prognosis factor. Adjuvant chemotherapy has not demonstrated a clear advantage. Its most efficient modality is a combination including cisplatin. For upper urinary tract tumours, lymph node dissection may have an impact on survival but definitive conclusion is limited by the lack of surgical technique and indications standardisation.
Conclusion: Extended lymph node dissection improves survival of bladder cancer and prognosis assessment that could eventually be used to stratify patient requiring adjuvant treatment (level of evidence 3). Improvement on survival was also suggested for upper urinary tract tumors (level of evidence 4).
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http://dx.doi.org/10.1016/j.purol.2012.02.002 | DOI Listing |
J Gastrointest Surg
January 2025
Department of Gastroenterological Surgery. Electronic address:
SLAS Technol
January 2025
Department of Radiology, Huzhou First People's Hospital, Huzhou 313000, Zhejiang Province, China. Electronic address:
To evaluate the clinical value of multi-slice spiral CT in preoperative TNN staging and postoperative recurrence and metastasis of colon carcinoma, and to provide evidence for the reliability of CT in the diagnosis of colon carcinoma METHODS: 89 patients with colon carcinoma diagnosed pathologically in our hospital from July 2020 to April 2023 were selected retrospectively. The preoperative TNN staging and postoperative recurrence and metastasis were monitored by 64 row 128 layer spiral CT. The diagnostic coincidence rate, TNM staging coincidence rate and postoperative recurrent TNM staging accuracy were evaluated according to the pathological diagnosis RESULTS: The diagnostic coincidence rate of multi-slice spiral CT was 97.
View Article and Find Full Text PDFPhys Med
January 2025
IRCCS Humanitas Research Hospital, Radiotherapy and Radiosurgery Department, via Manzoni 56, 20089 Rozzano, Milan, Italy.
Purpose: Total marrow (lymph-node) irradiation (TMI/TMLI) is a radiotherapy technique irradiating the whole body of a patient. The limited couch travel range in modern linacs (130-150 cm) forces to split the TMI/TMLI delivery into two plans with opposite orientation. A dedicated field junction is necessary to achieve satisfactory target coverage in the overlapping region of the two plans.
View Article and Find Full Text PDFCell Rep
January 2025
Department of Microbiology, Tumor and Cell Biology, Division of Virology and Immunology, Karolinska Institutet, 171 65 Solna, Sweden. Electronic address:
Protective antibodies against HIV-1 require unusually high levels of somatic mutations introduced in germinal centers (GCs). To achieve this, a sequential vaccination approach was proposed. Using HIV-1 antibody knockin mice with fate-mapping genes, we examined if antigen affinity affects the outcome of B cell recall responses.
View Article and Find Full Text PDFACS Appl Mater Interfaces
January 2025
Sixth People's Hospital, School of Medicine & School of Biomedical Engineering, Shanghai Jiao Tong University, Shanghai 200030, P. R. China.
The use of dual-tracer contrast agents in clinical applications, such as sentinel lymph node (SLN) identification, offers significant advantages including enhanced accuracy, sensitivity, as well as comprehensive and multimodal visualization. In the current clinical practice, SLNs are typically marked prior to surgical resection by multiple and sequential injections of two tracers, the radioactive tracer and methylene blue (MB) dye. This imposes physical and psychological burden on patients and medical staff.
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