The authors investigated 1,291 patients who had undergone radical cystectomy for lymph node negative bladder cancer. The aim was to define the possible impact of the number of removed lymph nodes as well as lymphovascular invasion (LVI) on cancer-specific survival (CSS). The authors found that CSS was 72% in patients with less than 16 removed lymph nodes compared to 83% in patients with 16+ removed lymph nodes (p=0.01). Also, age, gender and LVI were independent prognostic factors for CSS in the Cox regressions models. The authors concluded that removal of a higher number of lymph nodes and absence of LVI improves CSS. These factors could possibly be used to stratify patients for adjuvant therapy.
This trial provides additional data that a higher number of lymph nodes are associated with better outcome. While LVI could be used to stratify patients for adjuvant therapy, the parameter number of removed lymph nodes is probably not a realistic one – at least in a world of a toxic chemotherapy with limited success.
Presented by Patrick J, Bastian, MD, et al. at the 26th Annual European Association of Urology (EAU) Congress - March 18 - 21, 2011 - Austria Centre Vienna, Vienna, Austria
Reported for UroToday by Christian Doehn, MD, PhD, Department of Urology, University of Lübeck Medical School, Lübeck Germany.
View EAU 2011 Annual Meeting Coverage
