Pelvic Lymphadenectomy and Radical Cystectomy for Transitional Cell Carcinoma of the Bladder with Pelvic Nodal Disease

Zincke, Horst; Patterson, David E.; Utz, David C.; Benson, Ralph C.

doi:10.1111/j.1464-410x.1985.tb06411.x

Cited by 40 publications

(6 citation statements)

References 7 publications

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“…The present results showed a 5-year survival rate of 25 % for patients with lymph node metastasis, and confirmed the previous finding that little involvement of nodes yielded better survival [2,3,6,28].…”

Section: Discussionsupporting

confidence: 80%

Multivariate Evaluation of Determinants Affecting Regional Lymph Node Metastasis and Survival in Bladder Cancer Patients Who Underwent Radical Cystectomy

Takashi¹,

Nagai²,

Murase³

et al. 1989

Urol Int

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To elucidate the relative importance of clinicopathologic factors affecting regional lymph node metastasis and survival in bladder cancer patients, multivariate analyses by the logistic regression model and proportional hazards model were performed for 86 patients who underwent radical cystectomy between 1978 and 1988. Clinicopathologic factors included in the analysis were sex, age, prior tumor history, time from onset of symptoms to cystectomy, and tumor characteristics (size, number, growth pattern, grade, stage, infiltration pattern, lymphatic invasion, lymphocytic infiltration around tumors, and lymph node metastasis). Nineteen of eighty-six patients (22%) had regional lymph node metastasis. Univariate analysis showed that lymph node metastasis was related to stage (p = 0.0006), lymphatic invasion (p = 0.006) and infiltration pattern (p = 0.02). Multivariate analysis revealed that stage is the only determinant of statistical significance for lymph node metastasis. High-stage tumors (pT3a-pT4) had 15 times higher risk for lymph node metastasis than low-stage tumors (pTis-pT2). The 5-year survival rates were 25 and 75% for patients with and without lymph node metastasis, respectively. Proportional hazards model revealed that stage is the most significant determinant (p = 0.0001) for survival, followed by lymph node metastasis with borderline significance (0.005 < p < 0.1). A two-factor model consisting of stage and lymph node metastasis yielded corrected hazard ratios of 14.7 for stage and 2.3 for lymph node metastasis. The present study quantitatively confirms previous univariate analyses of factors affecting lymph node metastasis and survival in patients undergoing radical cystectomy.

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Section: Discussionsupporting

confidence: 80%

Multivariate Evaluation of Determinants Affecting Regional Lymph Node Metastasis and Survival in Bladder Cancer Patients Who Underwent Radical Cystectomy

Takashi¹,

Nagai²,

Murase³

et al. 1989

Urol Int

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“…Our experience, like that of others [6,7], confirms that pelvic lymphadenectomy does not substantially in crease the morbility associated with cystectomy. As re gards the curative effects of pelvic lymphadenectomy, patients with multiple lymph node involvement in our study failed to confirm the 5-year survival rate of nearly 40% for pT4 M+ envisaged by Skinner et al [7], These optimistic results have not be confirmed by other au thors yet [6],…”

Section: Discussionsupporting

confidence: 69%

“…As re gards the curative effects of pelvic lymphadenectomy, patients with multiple lymph node involvement in our study failed to confirm the 5-year survival rate of nearly 40% for pT4 M+ envisaged by Skinner et al [7], These optimistic results have not be confirmed by other au thors yet [6],…”

Section: Discussioncontrasting

confidence: 54%

Prognosis of Bladder Cancer III. The Value of Radical Cystectomy in the Management of Invasive Bladder Cancer

Pagano¹,

Guazzieri²,

Artibani³

et al. 1988

Eur Urol

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“…When the results are positive, surgical intervention must be abandoned. The follow-up of these patients has demonstrated that the eventual pal liative results are more illusory than real [14,18]. Only 1 of the 38 patients (2%) had a 4-year survival.…”

Section: Methodsmentioning

confidence: 99%

Value of Radical Cystectomy in Bladder Cancer with Pelvic Node Involvement

Zungri¹,

Chéchile²,

Sarroca³

et al. 1988

Eur Urol

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Of the 241 patients with bladder cancer treated with cystectomy and urinary diversion between January, 1978, and May, 1985, pelvic lymphadenectomy was performed in 150. In 41 of the 150 patients, pelvic node involvement was shown in the pathology study (27%). The preoperative clinical stages showed bladder muscule invasion in all 41 cases. Node invasion was found in 16/77 cases with radiation therapy and in 25/73 cases without radiation therapy (p < 0.05). Operative mortality was 3 cases (7.3%). Of the 38 patients who survived the operation, 35 (94%) died of cancer within an average of 8 months. Twenty-seven showed 1-3 pelvic nodes involved, 7 showed 4-6, and 4 patients had more than 6 nodes involved. These differences between survival rates are not statistically significant (p = 0.35). Two patients died of a disease not related to the tumor, and only 1 is alive 4 years after operation (2 %).

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Pelvic Lymphadenectomy and Radical Cystectomy for Transitional Cell Carcinoma of the Bladder with Pelvic Nodal Disease

Cited by 40 publications

References 7 publications

Multivariate Evaluation of Determinants Affecting Regional Lymph Node Metastasis and Survival in Bladder Cancer Patients Who Underwent Radical Cystectomy

Multivariate Evaluation of Determinants Affecting Regional Lymph Node Metastasis and Survival in Bladder Cancer Patients Who Underwent Radical Cystectomy

Prognosis of Bladder Cancer III. The Value of Radical Cystectomy in the Management of Invasive Bladder Cancer

Value of Radical Cystectomy in Bladder Cancer with Pelvic Node Involvement

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