Dokumentenart: | Artikel | ||||
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Titel eines Journals oder einer Zeitschrift: | World Journal of Urology | ||||
Verlag: | SPRINGER | ||||
Ort der Veröffentlichung: | NEW YORK | ||||
Band: | 30 | ||||
Nummer des Zeitschriftenheftes oder des Kapitels: | 6 | ||||
Seitenbereich: | S. 807-814 | ||||
Datum: | 2012 | ||||
Institutionen: | Medizin > Lehrstuhl für Urologie | ||||
Identifikationsnummer: |
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Stichwörter / Keywords: | INVASIVE BLADDER-CANCER; TRANSITIONAL-CELL CARCINOMA; LYMPH-NODES; PELVIC LYMPHADENECTOMY; PROSTATE-CANCER; DISSECTION; STANDARDIZATION; PROGNOSIS; SURVIVAL; NUMBER; Bladder cancer; Survival; Recurrence; Radical cystectomy; Lymph node; Transitional cell carcinoma | ||||
Dewey-Dezimal-Klassifikation: | 600 Technik, Medizin, angewandte Wissenschaften > 610 Medizin | ||||
Status: | Veröffentlicht | ||||
Begutachtet: | Ja, diese Version wurde begutachtet | ||||
An der Universität Regensburg entstanden: | Ja | ||||
Dokumenten-ID: | 63090 |
Zusammenfassung
To determine whether the number of lymph nodes (LNs) examined is associated with outcomes in patients without nodal metastasis after radical cystectomy (RC). We retrospectively analyzed data from 4,188 patients treated at 12 centers with RC and pelvic lymphadenectomy without neo-adjuvant chemotherapy for urothelial carcinoma of the bladder (UCB). Outcomes of patients without LN metastasis (n = ...
Zusammenfassung
To determine whether the number of lymph nodes (LNs) examined is associated with outcomes in patients without nodal metastasis after radical cystectomy (RC). We retrospectively analyzed data from 4,188 patients treated at 12 centers with RC and pelvic lymphadenectomy without neo-adjuvant chemotherapy for urothelial carcinoma of the bladder (UCB). Outcomes of patients without LN metastasis (n = 3,088) were examined according to the LN yield analyzed as continuous variable, tertiles, and using the cutoffs of a parts per thousand yen9 and a parts per thousand yen20. The median nodal yield was 18 (range 1-123; IQR:20). A total of 2591 (84 %) and 1445 (47 %) patients had a LN yield a parts per thousand yen9 and a parts per thousand yen20, respectively. Median follow-up was 47 months (IQR:70). In multivariable analyses that adjusted for the standard clinicopathologic factors, higher LN yield was associated with a decreased risk of disease recurrence (continuous: HR = 0.996, p = 0.05; 3rd vs 1st tertile: HR = 0.853, p = 0.048; cutoff a parts per thousand yen20: HR = 0.851, p = 0.032). In the subgroups of patients with muscle-invasive UCB or those with a parts per thousand yen9 LN removed, LN yield was not associated with outcomes (p values > 0.05). In this large multicenter cohort of patients with node-negative UCB, higher nodal yield improved recurrence-free survival when all patients were analyzed. Patients with a high LN yield (a parts per thousand yen20 LN removed or 3rd tertile) had the largest benefit. The lack of prognostic significance of LN yield in patients with muscle-invasive UCB or those stratified by 9 LNs removed suggests that this effect is weak. Further prospective studies are needed to help identify preoperatively the optimal template for each patient.
Metadaten zuletzt geändert: 19 Dez 2024 09:33