Is radical cystectomy indicated in patients with regional lymphatic metastases?

The records of 21 patients who had radical cystectomies for the treatment of locally advanced bladder cancer and were found to have regional lymphatic metastases have been reviewed. Ten of these patients had only one lymph node involved (N1), and 11 patients had metastases in more than one lymph node (N2-3). Four patients with N1 disease and 1 patient with N2-3 disease survived tumor-free greater than forty months postoperatively. Radical cystectomy can produce long-term disease-free survival in some patients with limited pelvic metastases.