[Tumor embolization to the lymphatic vessel structures of the bladder wall (L+). Its effect on the course of bladder tumors].
A retrospective study was conducted in patients with bladder tumors equal to or higher than stage T1 to determine the influence on survival of tumor cell invasion of the microscopic lymphatic vessels of the bladder wall. Sixty-two patients were studied (34 recurrent and 28 primary tumors). Evidence of microscopic lymphatic invasion was disclosed following TUR (48 cases) and cystectomy (14 cases). Overall and with a mean follow up of 27 months, 25% of the patients are alive and tumor free, 51.6% had died from the tumor (90% less than 3 years following diagnosis). Forty-five percent had lymph node metastasis and 56.6% node and organ metastases. For a time interval of over 6 months between the diagnosis of L + and definitive treatment, there was an 80% mortality versus 43% when treatment was concurrent with diagnosis. Finally, survival was much better in patients submitted to radical surgery. We can conclude from the present study that evidence of tumor invasion of the lymphatic vessels must be routinely sought by the pathologist in order to identify those patients with a high probability of tumor dissemination.
Ricos Torrent
J V
JV
Servicio de Urología, Instituto Valenciano de Oncología, España.
Iborra Juan
I
I
Casanova Ramón-Borja
J
J
Monrós Lliso
J L
JL
Dumont Martínez
R
R
Solsona Narbón
E
E
D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D017024:Chemotherapy, Adjuvant; D003131:Combined Modality Therapy; D006801:Humans; D008207:Lymphatic Metastasis; D008208:Lymphatic System / Q000473:pathology; D009362:Neoplasm Metastasis; D009367:Neoplasm Staging; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D016019:Survival Analysis; D001743:Urinary Bladder / Q000473:pathology; D001749:Urinary Bladder Neoplasms / Q000401:mortality / Q000473:pathology* / Q000601:surgery / Q000628:therapy
La embolización tumoral de las estructuras vásculo-linfáticas de la pared vesical (L+). Su influencia en la evolución de los tumores vesicales.