Comparisons between Standard and Extended Pelvic Lymph Node Dissections During Radical Cystectomy in Patients with Bladder Cancer: Emphasis on Staging Ability and Perioperative Complications.
10.22465/kjuo.2016.14.3.124
- Author:
Sang Eun LEE
1
;
Hakmin LEE
;
Hyun Hwan SUNG
;
Seong Il SEO
;
Seong Soo JEON
;
Hyun Moo LEE
;
Han Yong CHOI
;
Byong Chang JEONG
Author Information
1. Department of Urology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. bc2.jung@samsung.com
- Publication Type:Original Article
- Keywords:
Urinary bladder neoplasms;
Radical cystectomy;
Lymph node excision
- MeSH:
Classification;
Cystectomy*;
Humans;
Lymph Node Excision*;
Lymph Nodes*;
Prospective Studies;
Urinary Bladder Neoplasms*;
Urinary Bladder*;
Urinary Diversion
- From:Korean Journal of Urological Oncology
2016;14(3):124-129
- CountryRepublic of Korea
- Language:English
-
Abstract:
PURPOSE: We compared the staging ability and early complications of standard and extended pelvic lymph node dissection (sPLND and ePLND, respectively) in patients with localized bladder cancer during radical cystectomy. MATERIALS AND METHODS: We prospectively collected and analyzed the data of 261 patients who underwent radical cystectomy for localized bladder cancer. The resected lymph nodes were categorized according to anatomic locations and were carefully inspected by an experienced pathologist. The perioperative complications were classified using the Clavien-Dindo classification system. RESULTS: The 2 groups showed no significant differences in preoperative characteristics except for preoperative clinical stage (p=0.015). There were no significant differences in pathologic outcomes including pathologic stage, positive surgical margin, and lymphovascular invasion (all p>0.05), but the sPLND group showed a significantly higher cellular grade (p<0.001). The ePLND group showed a higher number of removed lymph nodes than the sPLND group (p=0.015) and a higher rate of positive lymph node invasion (35.8% vs. 28.9%). There were no significant differences in complication rates according to the extent of lymph dissection and urinary diversion type, respectively (p=0.063 and p=0.486). CONCLUSIONS: The ePLND showed more accurate nodal staging ability with comparable complication rates when compared to sPLND in patients who underwent radical cystectomy for localized bladder cancer. A further, larger prospective study is needed to confirm the result of the present study.
