title: Retrospective analysis of outcome in patients with nodal metastases from transitional cell carcinoma of lower urinary tract.
abstract: OBJECTIVE
  To determine the outcome in patients with nodal metastases from transitional cell carcinoma (TCC) using currently available surgical and chemotherapeutic techniques.
  
  
  METHODS
  A retrospective analysis of all patients with TCC of the lower urinary tract who underwent radical cystectomy or lymph node dissection at our institution since 1980 was performed. Thirty-one patients were identified who had documented pelvic lymph node metastases prior to or at the time of radical cystectomy. These patients' records were reviewed in-depth with regard to treatment approach, presenting features, and outcome.
  
  
  RESULTS
  Outcome was poor despite the treatment approach taken, including whether or not chemotherapy was administered prior to or after cystectomy. Median survivals of patients receiving no chemotherapy, adjuvant chemotherapy, and neoadjuvant chemotherapy were 14.5, 9.5, and 15.0 months, respectively. Only 4 of 28 patients survived more than three years, and only one of these received chemotherapy.
  
  
  CONCLUSIONS
  Survival of patients with lymph node metastases from transitional cell carcinoma remains poor despite aggressive surgical therapy and the use of adjuvant or neoadjuvant platinum-based chemotherapy.
authors.affiliation: Department of Urology, Vanderbilt University Medical Center, Nashville, Tennessee.
authors.forename: M O
authors.initials: MO
authors.lastname: Koch
authors.forename: D M
authors.initials: DM
authors.lastname: Coussens
mesh_terms: D000206:Actuarial Analysis; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000627:therapeutic use; D002295:Carcinoma, Transitional Cell / Q000401:mortality / Q000556:secondary* / Q000628:therapy*; D003131:Combined Modality Therapy; D015653:Cystectomy; D005500:Follow-Up Studies; D006801:Humans; D008197:Lymph Node Excision; D008207:Lymphatic Metastasis; D008875:Middle Aged; D012189:Retrospective Studies; D015996:Survival Rate; D016896:Treatment Outcome; D001749:Urinary Bladder Neoplasms / Q000401:mortality / Q000556:secondary* / Q000628:therapy*
chemical_list: D000970:Antineoplastic Agents