Cancer UrologyCancer UrologyОнкоурология1726-97761996-1812Publishing House ABV Press104510.17650/1726-9776-2008-4-4-65-70DIAGNOSIS AND TREATMENT OF URINARY SYSTEM TUMORS. URINARY BLADDER CANCERДИАГНОСТИКА И ЛЕЧЕНИЕ ОПУХОЛЕЙ МОЧЕПОЛОВОЙ СИСТЕМЫ. Рак мочевого пузыряImportance and extent of lymph node dissection in the treatment of patients with bladder cancerЗначение и объем тазовой лимфаденэктомии в лечении больных раком мочевого пузыряPetrovS. B.ПетровС. Б.
Russian Federation
KorolV. D.КорольВ. Д.
Russian Federation
RevaS. A.РеваС. А.
Russian Federation
KirichenkoM. V.КириченкоМ. В.
Russian Federation

St. Petersburg

г. Санкт-Петербург

S.M. Kirov Military Medical AcademyВоенно-медицинская академия им. С.М. КироваProf. N.N. Petrov Research Institute of OncologyНИИ онкологии им. проф. Н.Н. Петрова301220084465701302202013022020https://oncourology.abvpress.ru/oncur/article/view/1045

Purpose: The benefit of pelvic lymph node dissection in patients with bladder cancer remains controversial. We have compared these methods of dissection in regard to the following parameters: number of extracted lymph nodes, frequency and location of identifiable metastases, complications rate, and time before development of relapses. Also we have estimated influence of clinical and intra-operative regional changes on a choice of a extent of lymph node dissection.

Materials and methods: Analysis included data on 59 patients who underwent radical cystectomy for bladder cancer between 2002 and 2008. Extended lymph node dissection was carried out in 18 patients (30,5%), and limited lymph node dissection — in 41 (69,5 %) patients.

Results: The average quantity of removed lymph nodes was 11,2 in cases of limited and 20,8 — in cases of extended lymph node dissection. Consequently, the number of revealed metastases has increased from 21,9 to 33,3%. Complex estimation of preoperative and intraoperative data has demonstrated the greatest efficiency in diagnostics of changes in lymph nodes. Among perioperative complications only frequency of lymphorrhea has appeared to be higher in patients after extended lymph node dissection. Disease-free survival rate was 9,8 months (9,4 in cases of limited and 10,1 — in cases of extended dissection).

Conclusions: Extended pelvic lymph node dissection should be recommended as a component of radical cystectomy with diagnostic and, probably, with the therapeutic purpose, especially in patients with suspicion for lymph nodes involvement arisen pre- and/or intra-operatively. Both clinical examination and intra-operative and qualitative pathomorphologic evaluation of regional lymph nodes are very important for full value staging of bladder cancer.

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