title: [Effects of performing pelvic lymph node dissection before versus after radical cystectomy].
abstract: OBJECTIVE
  To explore the efficacies of extended pelvic lymph node dissection (e-PLND) before or after radical cystectomy (RC).
  
  
  METHODS
  From January 2003 to January 2013, a total of 107 patients underwent e-PLND plus RC. And their relevant clinical data were reviewed. Their median age was (62 ± 10) years. The e-PLND were divided into 10 regions and 6 groups according to the anatomic sites. Forty-seven (43.9%) underwent RC after e-PLND (group A) and 60 (56.1%) had RC before e-PLND (group B). Two groups were compared for operative duration, numbers of lymph nodes removed, metastatic rates of lymph node, dissected lymph node positive rates and operative complications. The results were analyzed with Chi-square or Student's test.
  
  
  RESULTS
  Clinicopathological characteristics were comparable for two groups (P > 0.05). The mean operative durations of e-PLND were similar in both groups ( (83 ± 27) vs (78 ± 24) min , P > 0.05). The mean operative durations of RC were significantly shorter in group A than those in group B ( (79 ± 41) vs (113 ± 44) min, P < 0.01) . The mean number of lymph nodes removed (25.5 ± 9.7 vs 29.0 ± 8.4) and the mean number of lymph nodes removed at internal iliac (5.7 ± 2.9 vs 7.2 ± 3.5) and presacral (1.3 ± 1.1 vs 2.5 ± 1.6) regions were significantly fewer in group A than those in group B (all P < 0.05). The metastatic rates of lymph node (34.0% (16/47) vs 31.7% (19/60)), dissected lymph node positive rates (9.0% (108/1197) vs 7.5% (130/1743)) and operative complications (23.4% (11/47) vs 20.0% (12/60)) were similar in both groups (all P > 0.05).
  
  
  CONCLUSIONS
  RC is performed preferably after e-PLND, and internal iliac and presacral area should be dissected for additional lymph nodes after RC.
authors.affiliation: Department of Urology, Jinhua Hospitol, Zhejiang University, Jinhua 321000, China. Email: yzyz-003@sohu.com.
authors.forename: Zai-sheng
authors.initials: ZS
authors.lastname: Zhu
authors.forename: Min
authors.initials: M
authors.lastname: Ye
authors.forename: Hong-qi
authors.initials: HQ
authors.lastname: Shi
authors.forename: Yi-bo
authors.initials: YB
authors.lastname: Zhou
authors.forename: Liang-you
authors.initials: LY
authors.lastname: Chen
authors.forename: Quan-qi
authors.initials: QQ
authors.lastname: Liu
authors.forename: Chun-ting
authors.initials: CT
authors.lastname: Zhang
authors.forename: Rong-li
authors.initials: RL
authors.lastname: Lou
authors.forename: Li-zhen
authors.initials: LZ
authors.lastname: Xu
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015653:Cystectomy / Q000379:methods*; D005260:Female; D006801:Humans; D008197:Lymph Node Excision; D008297:Male; D008875:Middle Aged; D010388:Pelvis / Q000601:surgery*; D012189:Retrospective Studies; D016896:Treatment Outcome