Association Between the Number of Dissected Lymph Nodes During Pelvic Lymphadenectomy and Cancer-Specific Survival in Patients with Lymph Node–Negative Urothelial Carcinoma of the Bladder Undergoing Radical Cystectomy
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- 作者：Matthias May MD (1)
Edwin Herrmann MD ; PhD (2)
Christian Bolenz MD (3)
Sabine Brookman-May MD (4)
Arne Tiemann MD (2)
Rudolf Moritz MD (2)
Hans-Martin Fritsche MD (4)
Maximilian Burger MD ; PhD (4)
Lutz Trojan MD. PhD (3)
Maurice S. Michel MD ; PhD (3)
Christian Wülfing MD ; PhD (2)
Stefan C. Müller MD ; PhD (5)
J?rg Ellinger MD (5)
Alexander Buchner MD (6)
Christian G. Stief MD ; PhD (6)
Derya Tilki MD ; PhD (6)
Wolf F. Wieland MD ; PhD (4)
Christian Gilfrich MD (1)
Thomas H?fner MD (7)
Markus Hohenfellner MD ; PhD (7)
Axel Haferkamp MD ; PhD (8)
Jan Roigas MD ; PhD (9)
Mario Zacharias MD (10)
Patrick J. Bastian MD ; PhD (6) - 刊名：Annals of Surgical Oncology
- 出版年：2011
- 出版时间：July 2011
- 年：2011
- 卷：18
- 期：7
- 页码：2018-2025
- 全文大小：377KB
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29. Capitanio U, Suardi N, Shariat SF, et al. Assessing the minimum number of lymph nodes needed at radical cystectomy in patients with bladder cancer. / BJU Int. 2009;103:1359-2. lass="external" href="http://dx.doi.org/10.1111/j.1464-410X.2008.08212.x">CrossRef - 作者单位：Matthias May MD (1)
Edwin Herrmann MD, PhD (2)
Christian Bolenz MD (3)
Sabine Brookman-May MD (4)
Arne Tiemann MD (2)
Rudolf Moritz MD (2)
Hans-Martin Fritsche MD (4)
Maximilian Burger MD, PhD (4)
Lutz Trojan MD. PhD (3)
Maurice S. Michel MD, PhD (3)
Christian Wülfing MD, PhD (2)
Stefan C. Müller MD, PhD (5)
J?rg Ellinger MD (5)
Alexander Buchner MD (6)
Christian G. Stief MD, PhD (6)
Derya Tilki MD, PhD (6)
Wolf F. Wieland MD, PhD (4)
Christian Gilfrich MD (1)
Thomas H?fner MD (7)
Markus Hohenfellner MD, PhD (7)
Axel Haferkamp MD, PhD (8)
Jan Roigas MD, PhD (9)
Mario Zacharias MD (10)
Patrick J. Bastian MD, PhD (6)
1. Department of Urology, St. Elisabeth Klinikum Straubing, Straubing, Germany
2. Urologische Universit?tsklinik, Universit?t Münster, Münster, Germany
3. Urologische Universit?tsklinik, Universit?t Heidelberg, Mannheim, Germany
4. Klinik für Urologie der Universit?t Regensburg, Caritas Krankenhaus St. Josef, Regensburg, Germany
5. Urologische Universit?tsklinik, Universit?t Bonn, Bonn, Germany
6. Urologische Universit?tsklinik, LMU München, München, Germany
7. Urologische Universit?tsklinik, Universit?t Heidelberg, Heidelberg, Germany
8. Urologische Universit?tsklinik, Universit?t Frankfurt/Main, Frankfurt/Main, Germany
9. Urologische Klinik, Vivantes Kliniken Am Urban und Im Friedrichshain Berlin, Berlin, Germany
10. Urologische Klinik, Vivantes Klinikum AVK Berlin, Berlin, Germany
文摘
Background A larger number of dissected lymph nodes (LN) during pelvic lymphadenectomy in patients with muscle-invasive transitional-cell carcinoma of the bladder treated by radical cystectomy (RC) is crucial for exact tumor staging and is associated with a positive oncological outcome. Methods Clinical and pathological records of 1291 patients undergoing RC due to LN-negative transitional-cell carcinoma of the bladder were summarized and evaluated in a multi-institutional database. The number of removed LNs and the presence or absence of lymphovascular invasion were assessed. On the basis of multivariate Cox regression analyses, a threshold number of removed LNs was defined that exerted an independent influence on cancer-specific survival (CSS). Results In multivariate Cox regression models for different numbers of removed LNs, a statistically significant enhancement of CSS could be demonstrated for a LN count of 16. Furthermore, the integration of the dichotomized LN count of 16 resulted in a statistically significantly enhanced predictive ability of the model for CSS. Patients with <16 and ?6 removed LNs showed CSS rates after 5?years of 72% and 83%, respectively (P?=?0.01). In addition, age, sex, pT stage, and lymphovascular invasion had independent influences on CSS in every Cox regression model. Conclusions In patients undergoing RC, removal of a higher LN count is associated with an improved oncological outcome. The information resulting from an assessment of lymphovascular invasion and an extended lymphadenectomy is critical for stratification of risk groups and identification of patients who might benefit from adjuvant treatment.