[Prognostic value of lymph node dissections in bladder cancer treated with radical cystectomy].
OBJECTIVE
The objective of this retrospective study was to analyse the impact of lymph node invasion on survival after radical cystectomy for bladder cancer.


METHODS
From 1988 to 2002, 192 patients underwent radical cystectomy for bladder cancer. Lymph node dissection was performed in 144 patients (75%) with bilateral pelvic lymph node dissection in 130 patients and extension to iliac chains in 14 patients.


RESULTS
Lymph node dissection had no impact on medical or surgical morbidity. Lymph node invasion was demonstrated in 35.4% of cases (51/144). Tumour effraction of the lymph node capsule was reported in 70.6% (36/51) of pN+ patients. Lymph node invasion was reported in 16.7% of pT0 patients, 0% of pTa, pTis, pT1 patients and 40, 47 and 48% of pT2, pT3 and pT4 patients, respectively. The mean follow-up was 40.3+/-3.5 months (median: 26.6; range 0-207 months). Overall, specific and recurrence-free survivals were significantly influenced by lymph node invasion (p<0.0001, p<0.0001, p<0.0001, respectively) and capsular effraction (p=0.0021, p=0.0027, p=0.0113, respectively).


CONCLUSIONS
Lymph node invasion and especially capsular effraction were significant prognostic factors of overall specific and recurrence-free survival.
Clinique urologique, CHU Hôtel-Dieu, 1, place Alexis-Ricordeau, 44093 Nantes cedex, France.
G
G
Braud
S
S
Battisti
G
G
Karam
O
O
Bouchot
J
J
Rigaud
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015653:Cystectomy / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008197:Lymph Node Excision; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012189:Retrospective Studies; D013997:Time Factors; D001749:Urinary Bladder Neoplasms / Q000401:mortality / Q000601:surgery*