[Lymphadenectomy for bladder cancer: current status and controversies]

Metzger, T; Thalmann, G N; Zehnder, P (2012). [Lymphadenectomy for bladder cancer: current status and controversies]. Urologe, 51(3), pp. 310-8. Berlin: Springer-Verlag 10.1007/s00120-012-2833-6

Preview

Text 120_2012_Article_2833.pdf - Published Version Available under License Publisher holds Copyright. Download (431kB) | Preview

Pelvic lymph node dissection is an integral part of the radical cystectomy procedure for patients with muscle-invasive bladder cancer. The optimal extent of the lymphadenectomy (LND) and mainly the proximal template boundary remain controversial issues. In view of the existing mapping studies and retrospective analyses, extended LND up to the mid-upper third of the common iliac vessels appears to provide further prognostic and therapeutic benefit and therefore should be defined as standard LND. This applies for all procedures irrespective of the choice of surgical approach (open surgery, minimally invasive approach). In this context total lymph node count is not a quality criterion because nodal yield is overly influenced by the individual patient's anatomy, surgical technique, template applied and pathological work-up. Consecutively, considerable inter-institutional differences result, which render any comparison impossible. Lymph node density is thought to be a superior prognostic factor, but it is similarly influenced by the above-mentioned factors. Concerning molecular techniques to improve the sensitivity of postoperative nodal staging further research is necessary. The two ongoing prospective randomized trials will potentially help to further define the optimal LND template.

Interest & Impact

Downloads

345 since deposited on 04 Oct 2013
52 in the past 12 months

Citations

5 Citations in Web of Science ®
6 Citations in Scopus

Search

in Google Scholar™

Services

Actions (login required)

Edit item

Actions (login required)

Edit item