Related Experiment Videos
Pelvic lymph node dissection can be curative in patients with node positive bladder cancer
J Vieweg1, J E Gschwend, H W Herr
1Division of Urology, Duke University Medical Center, Durham, North Carolina, USA.
The Journal of Urology
|January 23, 1999
Summary
Bladder cancer with lymph node metastasis has a poor prognosis. However, P and N categories are key predictors of survival, suggesting some patients may benefit from surgery.
Area of Science:
- Oncology
- Urologic Oncology
Background:
- Bladder cancer metastasis to regional lymph nodes presents a significant clinical challenge.
- Accurate prognostic indicators are crucial for guiding treatment strategies in these patients.
Purpose of the Study:
- To identify predictors of disease-specific survival in a large cohort of bladder cancer patients with regional lymph node metastases.
- To evaluate the impact of clinical and pathological parameters on patient outcomes.
Main Methods:
- Retrospective analysis of 193 consecutive patients with regional lymph node metastases treated between 1980 and 1990.
- Univariate and multivariate analyses were performed to identify prognostic factors.
Main Results:
- Pathological T (pT) and N (pN) categories were identified as significant predictors of disease-specific survival (p=0.0001 and p=0.0006, respectively).
- Chemotherapy or irradiation did not demonstrate a beneficial impact on survival.
- Pathological grade and other histological features did not significantly affect survival outcomes.
Conclusions:
- Nodal metastases in bladder cancer confer a poor prognosis, even after radical surgery.
- Certain node-positive cases, particularly those with localized disease or low N category, may benefit from surgical intervention.
- Findings underscore the need for randomized clinical trials to evaluate neoadjuvant and adjuvant treatment strategies for node-positive bladder cancer.