Value of frozen sections of lymph nodes in pelvic lymphadenectomy in patients with invasive bladder tumor.
OBJECTIVE
We examined the reliability of classical lymph node evaluation methods. We compared the results of preoperative computed tomography (CT) and perioperative frozen section examination of lymph nodes in patients on whom radical cystectomy was performed because of invasive bladder tumors.


METHODS
A total of 142 patients, in whom radical cystectomy was performed because of invasive bladder tumors between the years 1994 and 2005 in our clinic, and 284 pelvic lymph node regions were evaluated retrospectively. For each of the pelvic lymph node region, the conditions of the lymph nodes according to CT and in frozen sections were compared with the final pathology reports of the surgical specimens.


RESULTS
Lymph node involvement was found in 36 pelvic regions out of 284 in the final pathology. It had been possible to show only two of the 36 positive lymph nodes in preoperative CT. Frozen section results of the 29 pelvic lymph node regions out of 36 that were involved according to the final pathology were positive also according to frozen section results. On the other hand, in all the 29 lymph node regions those that were positive according to frozen section had lymph node involvement in the final pathology.


CONCLUSIONS
We recommend the performance of frozen section examination on obturator plus internal iliac lymph nodes when deciding extended lymph node dissection, and the performance of extended lymph node dissection only if the result is positive.
Ugurlu
Ozgur
O
Department of 2nd Urology, Ankara Numune Education and Research Hospital, Ankara, Turkey. ugurluozgur@hotmail.com
Adsan
Oztug
O
Tul
Mesut
M
Kosan
Murat
M
Inal
Gurdal
G
Cetinkaya
Mesut
M
D015653:Cystectomy; D005260:Female; D006801:Humans; D008198:Lymph Nodes / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery; D008207:Lymphatic Metastasis; D008297:Male; D009361:Neoplasm Invasiveness; D010388:Pelvis / Q000000981:diagnostic imaging / Q000473:pathology; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D021701:Sentinel Lymph Node Biopsy / Q000379:methods; D014057:Tomography, X-Ray Computed / Q000379:methods; D001749:Urinary Bladder Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery