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World Journal of Urology

Erschienen in:

01.08.2011 | Original Article

Does the greater number of lymph nodes removed during standard lymph node dissection predict better patient survival following radical cystectomy?

verfasst von: Jinsung Park, Seongcheol Kim, In Gab Jeong, Cheryn Song, Jun Hyuk Hong, Choung-Soo Kim, Hanjong Ahn

Erschienen in: World Journal of Urology | Ausgabe 4/2011

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Abstract

Purpose

To determine whether the number of lymph nodes (LNs) removed during radical cystectomy (RC) and pelvic LN dissection (LND) is associated with patient survival.

Methods

Data on 450 patients who underwent RC and standard bilateral pelvic LND for urothelial bladder cancer without receiving neoadjuvant chemotherapy were reviewed. The extent of LND included common iliac artery bifurcation proximally, genitofemoral nerve laterally and the pelvic floor caudally. The impact of the number of LNs removed, analyzed as both continuous and categorical variables, on cancer-specific survival (CSS) and recurrence-free survival (RFS) was analyzed.

Results

The median number of LNs removed was 18 (mean 19.6, range 10–94). Of total 450 patients, 129 (28.7%) had node-positive (N +) disease. For entire patients, the number of LNs removed was not associated with CSS and RFS in the analysis with continuous variable (P = 0.715; P = 0.442, respectively), quartiles (P = 0.924; P = 0.676, respectively), or <18 versus ≥18 LNs removed (5-year CSS rates: 67.0% vs. 69.4%, P = 0.679; 5-year RFS rates = 59.4% vs. 60.6%, P = 0.725, respectively). Similarly, the number of LNs removed was not associated with CSS and RFS in both N0 and N + patients, and in each T stage. Multivariate analyses showed that T stage and lymphovascular invasion were significant predictors for survival in N0 patients, whereas adjuvant chemotherapy and LN density were predictors for survival in N + patients.

Conclusions

If meticulous LND was performed based on standardized LND template during RC, the number of LNs removed was not associated with patient survival.

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Titel: Does the greater number of lymph nodes removed during standard lymph node dissection predict better patient survival following radical cystectomy?
verfasst von: Jinsung Park
Seongcheol Kim
In Gab Jeong
Cheryn Song
Jun Hyuk Hong
Choung-Soo Kim
Hanjong Ahn
Publikationsdatum: 01.08.2011
Verlag: Springer-Verlag
Erschienen in: World Journal of Urology / Ausgabe 4/2011
Print ISSN: 0724-4983
Elektronische ISSN: 1433-8726
DOI: https://doi.org/10.1007/s00345-011-0644-9

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Does the greater number of lymph nodes removed during standard lymph node dissection predict better patient survival following radical cystectomy?