Standardization of pelvic lymphadenectomy performed at radical cystectomy

摘要: BACKGROUND. The number of lymph nodes (LNs) removed during radical cystectomy (RC) for transitional cell carcinoma (TCC) the bladder affects overall and disease-specific survival, but no consensus exists regarding minimum LNs that should be removed. The goal current study was to determine if a threshold exists, above which taking additional has clinical benefit. METHODS. A total 1121 patients were identified who underwent RC clinically localized TCC between January 1990 April 2004. To relation removal Cox proportional hazards model used with pathologic stage, age, comorbidity as covariates. A dose-response curve, adjusted covariates, modeled assess impact an increasing on survival. RESULTS. A median 9 (range, 0–53 LNs). In multivariable analysis, all covariates (number removed, stage disease, comorbidity) found predictive survival. curve versus survival revealed that, when probability did not plateau instead continued rise increased. CONCLUSIONS. No evidence is sufficient optimizing cancer outcomes limited or extended pelvic LN dissection performed RC. Instead, continues increases. This supports more at time RC, highlights challenges interpreting retrospective data. Cancer 2006. © 2006 American Society.