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Published on: May 12, 2019
Extranodal extension in node-positive bladder cancer: the continuing controversy.
In Gab Jeong1, Jae Y Ro, Seong Cheol Kim
1Department of Urology, Asan Medical Centre, University of Ulsan College of Medicine, Seoul, Korea.
BJU International
|November 13, 2010
Summary
Extranodal extension (ENE) does not independently predict outcomes for bladder cancer patients after radical cystectomy. Further prospective studies are needed to clarify the prognostic significance of ENE in node-positive bladder cancer cases.
Area of Science:
- Urology
- Oncology
- Pathology
Background:
- Radical cystectomy is a primary treatment for bladder cancer.
- Lymph node metastasis is a critical prognostic factor.
- The role of extranodal extension (ENE) in node-positive patients remains debated.
Purpose of the Study:
- To investigate the impact of extranodal extension (ENE) on recurrence-free survival (RFS) and disease-specific survival (DSS).
- To evaluate ENE as an independent prognostic factor in node-positive bladder cancer patients undergoing radical cystectomy.
Main Methods:
- Retrospective analysis of 112 node-positive patients who underwent radical cystectomy for urothelial carcinoma.
- Evaluation of recurrence-free survival (RFS) and disease-specific survival (DSS) based on ENE status.
- Multivariate analysis to adjust for other prognostic factors like lymph node density and adjuvant chemotherapy.
Main Results:
- Extranodal extension (ENE) was observed in 36.6% of patients.
- ENE presence correlated with advanced nodal status, more positive lymph nodes, and higher lymph node density.
- Multivariate analysis indicated that lymph node density and adjuvant chemotherapy were significant predictors of RFS and DSS, respectively.
- After adjustment for other factors, ENE was not a significant predictor of RFS or DSS.
Conclusions:
- Extranodal extension (ENE) is not an independent prognostic factor for node-positive bladder cancer patients post-radical cystectomy.
- Further prospective research is required to definitively establish the prognostic role of ENE.
