Department of Urology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.
We examined clinical outcomes in patients with bladder cancer who underwent radical cystectomy and had 1 positive lymph node compared to none or 2 positive lymph nodes.
We retrospectively analyzed data on 525 patients who underwent radical cystectomy and pelvic lymphadenectomy for urothelial carcinoma of the bladder and who had none, 1 or 2 positive lymph nodes. The effect of several variables on recurrence-free and disease specific survival was assessed.
Of the 525 patients pathological analysis revealed no positive lymph nodes in 448 with organ confined disease (311 or 59.2%) or extravesical disease (137 or 26.1%), 1 positive lymph node in 54 (10.3%) and 2 positive lymph nodes in 23 (4.4%). Five-year recurrence-free and disease specific survival rates were 36.9% and 52.2% in patients with 1 positive lymph node, 51.9% and 56.6% in those with extravesical lymph node negative disease (p = 0.178 and 0.504), and 16.3% and 21.7% in those with 2 positive lymph nodes (p = 0.027 and 0.036, respectively). Multivariate analysis showed that 2 positive lymph nodes were associated with lower recurrence-free and disease specific survival than 1 positive lymph node (HR 2.03, p = 0.021 and HR 2.20, p = 0.015, respectively). However, recurrence-free and disease specific survival rates were not statistically different between patients with extravesical lymph node negative disease and those with 1 positive lymph node (HR 0.70, p = 0.162 and HR 0.72, p = 0.219, respectively) after adjusting for other prognostic variables.
Patients with 1 positive lymph node had a prognosis similar to that in lymph node negative patients with extravesical extension. Patients with 1 positive lymph node had a better prognosis than those with 2 positive lymph nodes.
Written by:
Jeong IG, You D, Kim JW, Song C, Hong JH, Ahn H, Kim CS. Are you the author?
Reference: J Urol. 2011 Apr 13. Epub ahead of print.
doi: 10.1016/j.juro.2011.02.056
PubMed Abstract
PMID: 21496833
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