Results of treatment in patients with urinary bladder cancer metastasizing to regional lymph nodes
https://doi.org/10.17650/1726-9776-2007-3-3-35-41
Abstract
The data of 668 radical cystectomies were used to study the results of treatment in 151 (22,6%) patients with urinary bladder cancer (UBC) metastasizing to the regional lymph nodes and to evaluate the impact of lymphodissection extent on the detection rate of metastases and on survival.
In UBC, routine lymphodissection significantly increases the detection rate of regional metastases as compared with limited lymphodissection from 17,8 to 24,8% (p = 0,04). Expanded lymphodissection in patients with UBC with regional metastases could significantly increase overall 5-year survival (p = 0,006).
In patients with UBC metastasizing to the regional lymph nodes, the survival rates found after cystectomy using the currently available urine derivation techniques suggest that orthotopic urine derivation may be used in this group of patients after radical operation. Among all factors influencing survival in such patients, the degree of involvement of regional lymph nodes (p = 0,04) and the extent of lymphodissection (p = 0,02) are of independent prognostic value.
About the Authors
S. S. Krasnyi
N.N. Alexandrov Research Institute of Oncology and Medical Radiology
Belarus
Minsk
Belarus
Minsk
O. G. Sukonko
N.N. Alexandrov Research Institute of Oncology and Medical Radiology
Belarus
Minsk
Belarus
Minsk
A. I. Rolevich
N.N. Alexandrov Research Institute of Oncology and Medical Radiology
Belarus
Minsk
Belarus
Minsk
References
1. Мавричев А.С., Красный С.А., Поляков С.Л. и др. Онкоурология. Минск, БелЦНМИ; 2001.
2. Матвеев Б.П., Фигурин К.М., Карякин О.Б. Рак мочевого пузыря. М., Вердана; 2001.
3. Busby J.E., Evans C.P. Old friends, new ways: revisiting extended lymphadenectomy and neoadjuvant chemotherapy to improve outcomes. Curr Opin Urol 2004;14:251—7.
4. Campbell's Urology. 8th ed. P.C. Walsh, A.B. Retik, E.D. Vaughan and A. J. Wein (eds). Philadelphia, W.B. Saunders Co; 2002.
5. Herr H.W. The natural history of a T1 bladder cancer: life-long tumour diathesis. BJU Int 1999;84:1102—3.
6. Solsona E., Iborra I., Dumont R. et al. Risk groups in patients with bladder cancer treated with radical cystectomy: statistical and clinical model improving homogeneity. J Urol 2005;174:1226—30.
7. Stein J.P., Lieskovsky G., Cote R. et al. Radical cystectomy in the treatment of invasive bladder cancer: long-term results in 1054 patients. J Clin Oncol 2001;19:666—775.
8. Hautmann R.E., Stein J.P. Neobladder with prostatic capsule and seminal-sparing cystectomy for bladder cancer: A step in the wrong direction. Urol Clin North Am 2005;32(2):177—85.
9. Stenzl A., Nagele U., Kuczyk M. et al. Cystectomy — technical considerations in male and female patients. EAU Update Series 2005;(3):138—46.
10. Hoshi S., Orikasa S., Suzuki K. et al. Diagnosis and treatment of pelvic lymph node metastasis in bladder cancer. Int J Urol 1999;6:400—7.
11. Shvarts O., Han K.R., Seltzer M. et al. Positron emission tomography in urologic oncology. Cancer Control 2002;9:335—42.
12. Madersbacher S., Hochreiter W., Burkhard F.H. et al. Radical cystectomy for bladder cancer today a homogeneous series without neoadjuvant therapy. J Clin Oncol 2003;21:690—6.
13. Liedberg F., Mansson W. Lymph node metastasis in bladder cancer. Eur Urol 2006;49:13—21.
14. Stein J.P., Quek M.L., Skinner D.G. Lymphadenectomy for invasive bladder cancer: II. historical perspective and contemporary rationale. BJU Int 2006;97:232—7.
15. Stein J.P., Quek M.L., Skinner D.G. Lymphadenectomy for invasive bladder cancer: I. historical perspective and contemporary rationale. BJU Int 2006;97:227—31.
16. Herr H.W. Superiority of ratio based lymph node staging for bladder cancer. J Urol 2003;169:943—5.
17. Bochner B.H., Herr H.W., Reuter V.E. Impact of separate versus en block pelvic lymph node dissection on the number of lymph nodes retrieved in cystectomy specimens. J Urol 2001;169:2295—6.
18. Bochner B.H., Cho D., Herr H.W. et al. Prospectively packaged lymph node dissections with radical cystectomy: evaluation of node count variability and node mapping. J Urol 2004;172:1286—90.
19. Ather M.H., Fatima S., Sinanoglu O. Extent of lymphadenectomy in radical cystectomy for bladder cancer. World J Surg Oncol 2005;43(3):1—5.
20. Leissner J., Ghoneim M.A. Abol-Enein H. et al. Extended radical lymphadenectomy in patients with urothelial bladder cancer: results of a prospective multicenter study. J Urol 2004;171: 139—44.
21. Brössner C., Pycha A., Toth A. et al. Does extended lymphadenectomy increase the morbidity of radical cystectomy? BJU Int 2004;93:64—6.
22. Frank I., Cheville J.C., Blute M.L. et al. Transitional cell carcinoma of the urinary bladder with regional lymph node involvement treated by cystectomy: clinicopathologic features associated with outcome. Cancer 2003;97:2425—30.
23. Knap M.M., Lundbeck F., Overgaard J. The role of pelvic lymph node dissection as a predictive and prognostic factor in bladder cancer. Eur J Cancer 2003;39:604—13.
24. Stein J.P., Cai J., Groshen S., Skinner D.G. Risk factors for patients with pelvic lymph node metastases following radical cystectomy with en block pelvic lymphadenectomy: the concept of lymph node density. J Urol 2003;170:35—41.
25. Fleischmann A., Thalmann G.N., Markwalder R., Studer U.E. Prognostic implications of extracapsular extension of pelvic lymph node metastases in urothelial carcinoma of the bladder. Am J Surg Pathol 2005;29:89—95.
26. Sanderson K.M., Stein J.P., Skinner D.G. The evolving role of pelvic lymphadenectomy in the treatment of bladder cancer. Urol Oncol 2004;22:205—13.
27. Herr H.W. Surgical factors in bladder cancer: more (nodes) + more (pathology) = less (mortality). BJU Int 2003;92:187—8.
28. Konety B.R., Joslyn S.A. Factors influencing aggressive therapy for bladder cancer: an analysis of data from the SEER program. J Urol 2003;170:1765—71.
29. Herr H.W., Faulkner J.R., Grossman H.B.R. et al. Surgical factors influence bladder cancer outcomes: a cooperative group report. J Clin Oncol 2004;22:2781—5.
30. Lebret T., Herve J.M., Yonneau L. et al. After cystectomy, is it justified to perform a bladder replacement for patients with lymph node positive bladder cancer? Eur Urol 2002;42:344—9.
31. Shekarriz B., Pontes J.E. Management of poor risk patients with muscleinvasive transitional cell carcinoma of the bladder. AUA Update Series 2001;20:90—5.
32. Nishiyama H., Habuchi T., Watanabe J. et al. Clinical outcome of a largescale multi-institutional retrospective study for locally advanced bladder cancer: a survey including 1131 patients treated during 1990—2000 in Japan. Eur Urol 2004;45:176—81.
Review
For citations:
Krasnyi S.S., Sukonko O.G., Rolevich A.I. Results of treatment in patients with urinary bladder cancer metastasizing to regional lymph nodes. Cancer Urology. 2007;3(3):35-41. (In Russ.) https://doi.org/10.17650/1726-9776-2007-3-3-35-41
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