title: Outcomes of single lymph node positive urothelial carcinoma after radical cystectomy.
abstract: OBJECTIVE
  We examined clinical outcomes in patients with bladder cancer who underwent radical cystectomy and had 1 positive lymph node compared to none or 2 positive lymph nodes.
  
  
  METHODS
  We retrospectively analyzed data on 525 patients who underwent radical cystectomy and pelvic lymphadenectomy for urothelial carcinoma of the bladder and who had none, 1 or 2 positive lymph nodes. The effect of several variables on recurrence-free and disease specific survival was assessed.
  
  
  RESULTS
  Of the 525 patients pathological analysis revealed no positive lymph nodes in 448 with organ confined disease (311 or 59.2%) or extravesical disease (137 or 26.1%), 1 positive lymph node in 54 (10.3%) and 2 positive lymph nodes in 23 (4.4%). Five-year recurrence-free and disease specific survival rates were 36.9% and 52.2% in patients with 1 positive lymph node, 51.9% and 56.6% in those with extravesical lymph node negative disease (p = 0.178 and 0.504), and 16.3% and 21.7% in those with 2 positive lymph nodes (p = 0.027 and 0.036, respectively). Multivariate analysis showed that 2 positive lymph nodes were associated with lower recurrence-free and disease specific survival than 1 positive lymph node (HR 2.03, p = 0.021 and HR 2.20, p = 0.015, respectively). However, recurrence-free and disease specific survival rates were not statistically different between patients with extravesical lymph node negative disease and those with 1 positive lymph node (HR 0.70, p = 0.162 and HR 0.72, p = 0.219, respectively) after adjusting for other prognostic variables.
  
  
  CONCLUSIONS
  Patients with 1 positive lymph node had a prognosis similar to that in lymph node negative patients with extravesical extension. Patients with 1 positive lymph node had a better prognosis than those with 2 positive lymph nodes.
authors.affiliation: Department of Urology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.
authors.forename: In Gab
authors.initials: IG
authors.lastname: Jeong
authors.forename: Dalsan
authors.initials: D
authors.lastname: You
authors.forename: Jong Won
authors.initials: JW
authors.lastname: Kim
authors.forename: Cheryn
authors.initials: C
authors.lastname: Song
authors.forename: Jun Hyuk
authors.initials: JH
authors.lastname: Hong
authors.forename: Hanjong
authors.initials: H
authors.lastname: Ahn
authors.forename: Choung-Soo
authors.initials: CS
authors.lastname: Kim
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002295:Carcinoma, Transitional Cell / Q000556:secondary* / Q000601:surgery*; D015653:Cystectomy / Q000379:methods; D005260:Female; D006801:Humans; D008197:Lymph Node Excision; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012189:Retrospective Studies; D001749:Urinary Bladder Neoplasms / Q000473:pathology* / Q000601:surgery*