The role and the extent of lymphadenectomy in patients with bladder cancer
Authors:
M. Babjuk
Published in the journal:
Urol List 2008; 6(2): 32-35
Summary
The pelvic lymph nodes represent the primary metastatic site in bladder carcinoma. The risk of lymph node involvement is increasing depending on the depth of tumor invasion into the bladder wall. Prognosis depends on the extent of lymph node involvement. The lymph node density (including not only the number of positive nodes but also the number of removed nodes) is considered to be the most important prognostic factor.
Pelvic lymphadenectomy is the most reliable staging procedure. Retrospective evaluations show the possible therapeutic benefit of the removal of more nodes; however the consensus concerning the extent of lymphadenectomy has not been achieved yet. Most authors recommend meticulous pelvic lymphadenectomy up to the common iliac bifurcation.
Key words:
bladder tumors, cystectomy, lymphadenectomy, lymph node density
Zdroje
1. Leissner J, Ghoneim MA, Abol-Enein H et al. Extended radical lymphadenectomy in patients with urothelial bladder cancer: results of prospective multicenter study. J Urol 2004; 171(1): 139–144.
2. Stein JP, Lieskovsky G, Cote R et al. Radical cystectomy in the treatment of invasive bladder cancer: long-term results in 1,054 patients. J Clin Oncol 2001; 19(3): 666–675.
3. Poulsen AL, Horn T, Steven K. Radical cystectomy: extending the limits of pelvic lymph node dissection improves survival for patients with bladder cancer confined to the bladder wall. J Urol 1998; 160(6): 2015–2020.
4. Leissner J, Hohenfellner R, Thüroff JW et al. Lymphadenectomy in patients with transitional cell carcinoma of the urinary bladder; significance for staging and prognosis. BJU Int 2000; 85(7): 817–823.
5. Vazina A, Dugi D, Shariat SF et al. Stage specific lymph node metastasis mapping in radical cystectomy specimens. J Urol 2004; 171(5): 1830–1834.
6. Abdel-Latif M, Abol-Enein H, El-Baz M et al. Nodal involvement in bladder cancer cases treated with radical cystectomy: incedence and prognosis. J Urol 2004; 172(1): 85–89.
7. Babjuk M, Hanuš T, Šafařík L et al. Radikální cystektomie u pacientů s nádory močového měchýře. Výsledky u 125 operovaných pacientů. čas Lék čes 2007; 146: 746–760.
8. Frazier HA, Robertson JE, Dodge RK et al. The value of pathologic factors in predicting cancer-specific survival among patients treated with radical cystectomy for transitional cell carcinoma of the bladder and prostate. Cancer 1993; 71: 3993–4001.
9. Ghoneim MA, El-Mekresh MM, El-Baz MA et al. Radical cystectomy for carcinoma of the bladder: critical evaluation of the results in 1,026 cases. J Urol 1997; 158 (2), 393–399.
10. Hautmann RE, Gschwend JE, de Petriconi RC et al. Cystectomy for transitional cell carcinoma of the bladder: results of surgery only series in the neobladder era. J Urol 2006; 176(2): 486–492.
11. Vieweg J, Gschwend JE, Herr HW et al. Pelvic lymph node dissection can be curative in patients with node positive bladder cancer. J Urol 1999; 161(2): 449–454.
12. Fleischmann A, Thalmann GN, Markwalder R et al. Extracapsular extension of pelvic lymph node metastases from urothelial carcinoma of the bladder is an independent prognostic factor. J Clin Oncol 2005; 23(10): 2358–2365.
13. Herr HW. Superiority of ratio based lymph node staging for bladder cancer. J Urol 2003; 169(3): 943–945.
14. Stein JP, Cai J, Groshen S et al. Risk factors for patients with pelvic lymph node metastases following radical cystectomy with en bloc pelvic lymphadenectomy: the concept of lymph node density. J Urol 2003; 170(1): 35–41.
15. Kassouf W, Leibovici D, Munsell MF et al. Evaluation of the relevance of lymph node density in a contemporary series of patients undergoing radical cystectomy. J Urol 2006; 176(1): 53–57.
16. Herr HW. The concept of lymf node density – is it ready for clinical practice? J Urol 2007; 177(4): 1273–1376.
17. Kassouf W, Agarwal PK, Herr HW, Munsell MF, Spiess PE, Brown GA et al. Lymph node density is superior to TNM nodal status in predicting disease-specific survival after radial cystectomy for bladder cancer: analysis of pooled data from MDACC and MSKCC. J Clin Oncol 2008; 26: 121–126.
18. Skinner DG. Management of invasive bladder cancer: a meticulous pelvic node dissection can make a difference. J Urol 1982; 128(1): 34–36.
19. Herr HW, Bochner BH, Dalbagni G et al. Impact of the number of lymph nodes retrieved on outcome in patients with muscle invasive bladder cancer. J Urol 2002; 167(3): 1295–1298.
20. Konety BR, Joslyn SA, O´Donnell MA. Extent of pelvic lymphadenectomy and its impact on outcome in patients diagnosed with bladder cancer: analysis of data from the surveillance, epidemiology and end results program data base. J Urol 2003; 169(3): 946–950.
21. Suttmann H, Kamradt J, Lehmann J, Stöckle M. Improving the prognosis of patients after radical cystectomy. Part I: the role of lymph node dissection. BJU Int 2007; 100(6): 1221–1224.
22. Sherif A, De La Torre M, Malmström P-U et al. Lymphatic mapping and detection of sentinel nodes in patients with bladder cancer. J Urol 2001; 166(3): 812–815.
23. Bochner BH, Cho D, Herr HW et al. Prospec-tively packaged lymph node dissections with radical cystectomy: evaluation of node count variability and node mapping. J Urol 2004; 172(1): 1286–1290.
24. Abol-Enein H, El-Baz M, Abd El-Hameed A et al. Lymph node involvement in patients with bladder cancer treated with radical cystectomy: a patho-anatomical study – a single center experience. J Urol 2004; 172(1): 1818–1821.
Štítky
Paediatric urologist UrologyČlánok vyšiel v časopise
Urological Journal
2008 Číslo 2
Najčítanejšie v tomto čísle
- Non-invasive blader cancer carcinoma – when should we start adjuvant intravesical instillation therapy and what to do in case of failure?
- Urinary diversion after cystectomy
- Complications of cystectomy and urinary diversion
- Sexual function sparing radical cystectomy