Value of radical cystectomy in bladder cancer with pelvic node involvement

Of the 241 patients with bladder cancer treated with cystectomy and urinary diversion between January, 1978, and May, 1985, pelvic lymphadenectomy was performed in 150. In 41 of the 150 patients, pelvic node involvement was shown in the pathology study (27%). The preoperative clinical stages showed bladder muscle invasion in all 41 cases. Node invasion was found in 16/77 cases with radiation therapy and in 25/73 cases without radiation therapy (p less than 0.05). Operative mortality was 3 cases (7.3%). Of the 38 patients who survived the operation, 35 (94%) died of cancer within an average of 8 months. Twenty-seven showed 1-3 pelvic nodes involved, 7 showed 4-6, and 4 patients had more than 6 nodes involved. These differences between survival rates are not statistically significant (p = 0.35). Two patients died of a disease not related to the tumor, and only 1 is alive 4 years after operation (2%).