title: Risk factors and clinical outcomes of patients with node-positive muscle-invasive bladder cancer.
abstract: Radical cystectomy and lymphadenectomy is a standard treatment for patients with high-grade, invasive bladder cancer. Although the absolute limits of lymphadectomy at the time of surgery have not been precisely defined, there is a growing body of evidence to suggest that an extended lymph node dissection may be beneficial for staging and survival in both node-negative and -positive bladder cancer patients. For lymph node-positive patients, several prognostic factors have been identified to provide risk stratification and direct the need for adjuvant treatment. These include: the pathological stage of the bladder tumor, extent of the lymphadenectomy and nodal tumor burden. The concept of lymph node density has also been identified as a prognostic factor. The literature and data on the extent of lymphadenectomy will be reviewed as well as the current prognostic variables and the benefits of adjuvant chemotherapy.
authors.affiliation: Department of Urology, USC/Norris Comprehensive Cancer Center, 1441 Eastlake Avenue, Suite 7416, MS#74, Los Angeles, CA 90089, USA. bruins_m@ccnt.usc.edu
authors.forename: Harman Maxim
authors.initials: HM
authors.lastname: Bruins
authors.forename: John P
authors.initials: JP
authors.lastname: Stein
mesh_terms: D017024:Chemotherapy, Adjuvant; D015653:Cystectomy; D018572:Disease-Free Survival; D006801:Humans; D008197:Lymph Node Excision; D008207:Lymphatic Metastasis; D009130:Muscle, Smooth / Q000473:pathology; D009361:Neoplasm Invasiveness; D009364:Neoplasm Recurrence, Local; D012307:Risk Factors; D001743:Urinary Bladder / Q000473:pathology; D001749:Urinary Bladder Neoplasms / Q000473:pathology / Q000601:surgery / Q000628:therapy