title: [Radical cystectomy for urothelial bladder cancer: prognostic impact of lymph node metastasis and soft tissue surgical margins].
abstract: OBJECTIVE
  To assess the association of soft tissue surgical margins (STSM) and/or lymph node metatstasis (pN+) with characteristics and outcomes of patients treated with radical cystectomy (RC) for urothelial carcinoma of the bladder (UCB).
  
  
  METHODS
  We retrospectively collected the data of 242 patients treated with RC and pelvic lymphadenectomy for UCB between January 2005 and June 2009. Different parameters were studied: age, PSAt, pathological stage of cystectomy specimen (pT and pN), tumor grade, number (nb) of nodes (N) in lymphadenectomy, nb of metastatic nodes (nb N+), bigger diameter of N+, ganglionic density, nb of N with capsular ruptur, associated CIS, associated prostate cancer, follow-up, global and specific survival, date and etiology of death.
  
  
  RESULTS
  Positive STSM were identified in 22 patients (9.1%) and lymph node metastasis in 59 (24.4%). pN+ status was significantly associated with lower global (GS) and specific survival (SS) (P<0.003). So was it for patients with positive STSM R+ with actuarial 3-year GS and SS respectively of 5% and 25% versus 35% and 43.9% no STSM (P<0.001).
  
  
  CONCLUSIONS
  Positive soft tissue surgical margin and/or lymph node metatstasis on cystectomy specimen is a strong predictor of GS and SS from urothelial carcinoma of the bladder. So it is for capsular rupture, ganglionic density greater or equal to 0.10 and nb of N in lymphadenectomy less than 14 for pN+ patients.
authors.affiliation: Service de chirurgie urologique, hôpital Nord, Marseille, France. harry.toledano@ap-hm.fr
authors.forename: H
authors.initials: H
authors.lastname: Toledano
authors.forename: C
authors.initials: C
authors.lastname: Bastide
authors.forename: M
authors.initials: M
authors.lastname: Thoulouzan
authors.forename: F
authors.initials: F
authors.lastname: Arroua
authors.forename: A
authors.initials: A
authors.lastname: Carcenac
authors.forename: E
authors.initials: E
authors.lastname: Ragni
authors.forename: E
authors.initials: E
authors.lastname: Huyghe
authors.forename: P
authors.initials: P
authors.lastname: Plante
authors.forename: D
authors.initials: D
authors.lastname: Rossi
authors.forename: M
authors.initials: M
authors.lastname: Soulie
mesh_terms: D000368:Aged; D002295:Carcinoma, Transitional Cell / Q000401:mortality* / Q000473:pathology / Q000601:surgery*; D015653:Cystectomy; D005260:Female; D006801:Humans; D008207:Lymphatic Metastasis; D008297:Male; D015999:Multivariate Analysis; D011379:Prognosis; D012189:Retrospective Studies; D001749:Urinary Bladder Neoplasms / Q000401:mortality* / Q000473:pathology / Q000601:surgery*