title: Role of lymph node dissection in management of bladder cancer.
abstract: Radical cystectomy (RC) with pelvic lymph node dissection (PLND) is the gold standard for treatment of muscle-invasive bladder cancer. Recent retrospective series suggest that extended PLND provides a survival benefit, probably by removing undetected micrometastases. There have been several studies suggesting the survival benefit of extended PLND, not only for patients with node-negative disease but also for those who are node positive. The optimal boundaries of PLND seem to be at least up to the level of aortic bifurcation, including Marcille's fossa, under the present circumstances. Because retrieval of more lymph nodes may help to improve the prognosis of patients, careful approaches should be considered both surgically and pathologically. PLND should be performed for all patients who undergo RC. Prospective randomized studies will give us the answer to the question of whether extended PLND should be performed routinely.
authors.affiliation: Department of Urology, Sapporo Medical University School of Medicine, South 1 West 16, Chuo-ku, Sapporo 060-8543, Japan. hkitamu@sapmed.ac.jp
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Kitamura
authors.forename: Naoya
authors.initials: N
authors.lastname: Masumori
authors.forename: Taiji
authors.initials: T
authors.lastname: Tsukamoto
mesh_terms: D002295:Carcinoma, Transitional Cell / Q000401:mortality / Q000556:secondary* / Q000601:surgery*; D015653:Cystectomy; D006801:Humans; D008197:Lymph Node Excision / Q000379:methods* / Q000401:mortality; D008198:Lymph Nodes / Q000473:pathology / Q000601:surgery*; D008207:Lymphatic Metastasis; D011379:Prognosis; D011446:Prospective Studies; D012189:Retrospective Studies; D016019:Survival Analysis; D001749:Urinary Bladder Neoplasms / Q000401:mortality / Q000601:surgery*