[The significance of extended pelvic lymphadenectomy in bladder cancer]

Despite radical surgery, invasive urothelial carcinoma has a high risk of systemic progression. This might be due to the presence of occult but already disseminated tumor cells in lymph nodes, blood, or bone marrow. In all retrospective series presented here, extended pelvic lymphadenectomy seems to provide a clear benefit for survival in pN0 and pN+ patients. Lymph node density and absolute number of positive lymph nodes appear to affect patient outcome and survival. However, only the randomized, prospective German LEA study will hopefully provide conclusive new data.