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Extended lymphadenectomy in bladder cancer.
1USC Institute of Urology, Keck School of Medicine, Los Angles, California, USA.
Current Opinion in Urology
|July 27, 2010
Summary
Radical cystectomy with extended pelvic lymph node dissection (PLND) improves survival rates for bladder cancer. This review covers benefits and surgical techniques for this advanced procedure.
Area of Science:
- Urology
- Surgical Oncology
- Oncology
Background:
- Radical cystectomy with pelvic lymph node dissection (PLND) is the standard treatment for invasive bladder cancer, offering optimal survival and staging.
- Extended PLND, encompassing lymphatic tissue to the aortic bifurcation, is increasingly recognized for its clinical benefits.
Purpose of the Study:
- To review the clinical benefits of radical cystectomy with extended lymphadenectomy for bladder cancer.
- To examine current surgical techniques for optimizing extended PLND.
Main Methods:
- Review of recent investigations and clinical studies on radical cystectomy and extended PLND.
- Analysis of data regarding survival rates, staging accuracy, and symptom control.
Main Results:
- Extended PLND is associated with improved recurrence-free and overall survival rates.
- Minimally invasive robotic techniques for radical cystectomy and extended PLND are feasible.
- Standardization of extended PLND templates is an active area of research.
Conclusions:
- All patients undergoing radical cystectomy for bladder cancer should consider extended PLND.
- Further randomized trials are needed to confirm benefits and identify optimal patient selection for extended PLND over standard PLND.
