Tumor location at trans-urethral resection is predictive of ipsilateral pelvic lymph-nodal metastases in patients undergoing radical cystectomy for bladder cancer.

To assess whether tumor location at diagnostic TURBT is predictive of ipsilateral nodal involvement in patients who underwent radical cystectomy (RC) with lymph-nodes dissection for bladder cancer (BCa).

All patients who underwent RC for BCa at a single institution between 2014-2023 were assessed. Tumor location at TURBT was defined as right-sided, median-line, left-sided, and diffused. Distribution in the percentage of ipsilateral positive lymph-nodes and number of ipsilateral positive lymph-nodes between tumor locations were assessed with Kruskal-Wallis tests. Linear regressions were fitted to assess whether left or right location, compared to the remaining locations grouped, was associated to the percentage and number of positive ipsilateral lymph-nodes.

239 patients were included. The number of ipsilateral positive lymph nodes was superior in right-sided tumors when compared to the rest of the bladder (0, I.Q.R. 0-1 vs. 0, I.Q.R. 0-0, P = 0.047), as well as the percentage of ipsilateral positive lymph-nodes (0, I.Q.R. 0-14.3 vs. 0, I.Q.R. 0-3.7, P = 0.042). The number of ipsilateral positive lymph-nodes in left-sided tumors was superior when compared to the rest of the bladder (0, I.Q.R. 0-1 vs. 0, I.Q.R. 0-0, P = 0.02), as well as the percentage (0, I.Q.R. 0-13.7 vs. 0, I.Q.R. 0-0, P = 0.036). At linear regression analyses, right- and left-sided tumors were associated with an increased percentage of ipsilateral positive lymph-nodes (P = 0,019 and P = 0,003) out of the total ipsilateral lymph-nodes excised.

Lateral wall tumor location at diagnostic TURBT (either right or left side) predicts a higher percentage of ipsilateral positive lymph-nodes s/p RC.

Urologic oncology. 2024 Oct 11 [Epub ahead of print]

Francesco Cianflone, Giovanni Mazzucato, Emanuele Rubilotta, Rossella Orlando, Nicola De Maria, Michele Boldini, Francesca Fumanelli, Francesca Montanaro, Greta Pettenuzzo, Luca Roggero, Alessandra Gozzo, Alberto Bianchi, Alessandro Veccia, Riccardo Giuseppe Bertolo, Maria Angela Cerruto, Alessandro Antonelli

Department of Urology, University of Verona, Azienda Ospedaliera Universitaria Integrata, Verona, Italy., Department of Urology, University of Verona, Azienda Ospedaliera Universitaria Integrata, Verona, Italy. Electronic address: .