Stage-specific impact of extended versus standard pelvic lymph node dissection in radical cystectomy

Giuseppe Simone, Rocco Papalia, Mariaconsiglia Ferriero, Salvatore Guaglianone, Emanuele Castelli, Devis Collura, Giovanni Muto, Michele Gallucci

Research output: Contribution to journalArticlepeer-review

Abstract

Objectives: To evaluate the impact of an extended versus a standard pelvic lymph node dissection on disease-free survival and cancer-specific survival of patients with non-metastatic muscle-invasive urothelial carcinoma of the bladder treated with radical cystectomy. Methods: We retrospectively analyzed data of 933 patients collected in two prospectively-maintained institutional databases between 2002 and 2010. Patients who met inclusion criteria (high-grade urothelial carcinoma, have not undergone neoadjuvant treatments, have not undergone salvage cystectomy) were included for analysis. The upper boundary was the iliac bifurcation for standard lymph-node dissection and the aortic bifurcation for the extended lymph node dissection, respectively. Univariable and multivariable Cox regression analyses were carried out to identify independent predictors of disease-free survival and cancer-specific survival and, subsequently, the effect of extended lymph node dissection was determined with a multivariable Cox analysis after stratifying for significant covariates. Results: At multivariable analysis, once adjusted for the effect of the other covariates, extended lymph node dissection was an independent predictor of disease-free survival (hazard ratio 1.95, P

Original languageEnglish
Pages (from-to)390-397
Number of pages8
JournalInternational Journal of Urology
Volume20
Issue number4
DOIs
Publication statusPublished - Apr 2013

Keywords

  • Bladder cancer
  • Lymph node dissection
  • Radical cystectomy
  • Urothelial carcinoma

ASJC Scopus subject areas

  • Urology

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