Extended Radical Lymphadenectomy in Patients With Urothelial Bladder Cancer:: Results of a Prospective Multicenter Study

Leißner, Joachim; Ghoneim, Mohamed A.; Abol‐Enein, Hassan; Thüroff, Joachim W.; Franzaring, Ludger; Fisch, Margit; Schulze, H.; Managadze, G.; Allhoff, E. P.; El‐Baz, Mahmoud; Kastendieck, H.; Buhtz, Peter; Kropf, Siegfried; Hohenfellner, R.; Wolf, Helmut K.

doi:10.1097/01.ju.0000102302.26806.fb

Cited by 412 publications

(381 citation statements)

References 14 publications

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“…Lymphadenectomy is performed at the time of cystectomy. Lymph node (LN) metastases, typically found in 20-25% of patients, are associated with increased local recurrence and disease progression, and may serve as an indicator of the need for further therapy [2][3][4][5].…”

Section: Introductionmentioning

confidence: 99%

“…Lymphadenectomy provides prognostic information and contributes to long-term cancer control and possibly cure of InvTCC [2][3][4][5][6][7]. The extent to which LN dissection should occur, however, has not been completely defined [8,9].…”

Section: Introductionmentioning

confidence: 99%

“…The extent to which LN dissection should occur, however, has not been completely defined [8,9]. The standard approach is to remove the major regional bladder-draining nodes [4]. However, the extent of LN dissection varies considerably from patient to patient (less than 5 nodes to greater than 75 nodes removed) [9].…”

Section: Introductionmentioning

confidence: 99%

“…Anatomical location cannot be used to identify SLNs owing to wide interpatient variation in LN drainage from the bladder [4]. Refined techniques using preoperative intravesical injection of radioactive tracer and blue dye have shown promise in identifying LNs that drain urinary bladder cancer [11][12][13].…”

Section: Introductionmentioning

confidence: 99%

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Sentinel Lymph Node Mapping of Invasive Urinary Bladder Cancer in Animal Models Using Invisible Light

Knapp¹,

Adams²,

DeGrand

et al. 2007

European Urology

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Objectives-With conventional methodology, sentinel lymph node (SLN) mapping of invasive urinary bladder cancer is technically challenging. This study was performed to determine the utility of invisible, near-infrared fluorescent (NIRF) light for patient-specific SLN mapping, in real time under complete image guidance.Methods-Lymphatic tracers, injection volume, NIRF excitation fluence rate, light collection of emitted fluorescence, and degree of bladder distension were systematically optimized in normal dogs and pigs. SLN mapping was then performed in pet dogs with naturally occurring invasive transitional cell carcinoma (InvTCC) of the urinary bladder, which closely mimics the human disease.Results-NIRF albumin (hydrodynamic diameter [HD], 7.4 nm) and NIRF quantum dots (15-20 nm HD) injected into the bladder wall resulted in identification of draining lymph nodes (LNs) in under 3 min. In both species, considerable variability in the lymphatic drainage was observed among individuals. Optimal SLN mapping was achieved with the use of superficial, serosal injection of NIRF tracer, with the bladder distended to an intraluminal pressure of 20-40 cm H 2 O. In dogs with InvTCC, NIRF tracers identified SLNs that were confirmed histologically to harbor metastases.Conclusions-The use of invisible NIRF light permits real-time, patient-specific identification of SLNs that drain bladder cancer. Intraluminal bladder pressure is a key parameter that needs to be controlled for optimal results. KeywordsBladder cancer; Fluorescence; Intraoperative imaging; Sentinel lymph node mapping * Corresponding author. Purdue University, Department of Veterinary Clinical Sciences, Lynn Hall of Veterinary Medicine, 625 Harrison St, West Lafayette, IN 47907-2026. Tel.765-494-9900; Fax: 765-496-1108. E-mail address: knappd@purdue.edu (D.W. Knapp). Take-home message This article describes successful use of intraoperative near-infrared light to identify sentinel lymph nodes (SLNs) draining invasive urinary bladder cancer in animals. This technology will permit studies of a new approach to identify SLNs at the time of cystectomy.Publisher's Disclaimer: This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Sentinel Lymph Node Mapping of Invasive Urinary Bladder Cancer in Animal Models Using Invisible Light

Knapp¹,

Adams²,

DeGrand

et al. 2007

European Urology

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“…8,9,11,12 In all these studies extended LA was recommended to patients with positive lymph nodes and associated with improved recurrence-free and/or cancer-specific and/or overall survival. Poulsen et al suggested that extending the limits of LA from the bifurcation of the common iliac vessels to the bifurcation of the aorta improves the recurrence-free survival rates for patients especially with tumor stages pT3a or less.…”

Section: Lymph Node Metastasis In Bladder Cancermentioning

confidence: 99%

The prognostic impact of pelvic lymph node metastasis and lymphovascular invasion on bladder cancer

et al. 2008

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Objectives: To present long-term results of a single-center series of patients undergoing bilateral pelvic lymphadenectomy and radical cystectomy for bladder cancer and to analyze the impact of pelvic lymph node metastasis and lymphovascular invasion on clinical outcome. Methods: Between 1986 and 2005 833 patients were treated with bilateral pelvic lymphadenectomy and radical cystectomy at our institution. 614 of them with valid clinical follow-up information and no neoadjuvant therapy could be evaluated. Results: Disease-free and overall survival in the entire cohort was 56.7% and 49.5% at 5 years and 52.4% and 38.2% at 10 years, respectively. 28.1% of all patients had pelvic lymph node metastasis. We found organ-confined tumor stages (ՅpT2) in 43.8%. Patients with non-organ-confined tumor stages (ՆpT3) and positive pelvic lymph nodes had a significantly shorter overall survival than those without lymph node metastasis (P < 0.0001). In the subgroup of ՅpT2, the presence of pelvic lymph node metastasis did not show a statistically significant effect on overall survival (P = 0.618). The presence of lymphovascular invasion was associated with an impaired survival (P < 0.0001). In multivariate analysis, pathological tumor stage (P < 0.0001), lymph node stage (ՆpT3) (P = 0.004) and lymphovascular invasion (P = 0.001) were independent prognostic parameters. Conclusions: According to the present series, survival for patients with ՅpT2 does not depend on the lymph node stage. Lymphovascular invasion is an independent parameter of impaired survival and should be determined routinely in cystectomy specimens to identify patients, who may benefit from adjuvant systemic therapy.

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Extended versus standard lymph node dissection for urothelial carcinoma of the bladder in patients undergoing radical cystectomy

Hwang

Sathianathen

Imamura

et al. 2019

Cochrane Database of Systematic Reviews

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Extended Radical Lymphadenectomy in Patients With Urothelial Bladder Cancer:: Results of a Prospective Multicenter Study

Cited by 412 publications

References 14 publications

Sentinel Lymph Node Mapping of Invasive Urinary Bladder Cancer in Animal Models Using Invisible Light

Sentinel Lymph Node Mapping of Invasive Urinary Bladder Cancer in Animal Models Using Invisible Light

The prognostic impact of pelvic lymph node metastasis and lymphovascular invasion on bladder cancer

Extended versus standard lymph node dissection for urothelial carcinoma of the bladder in patients undergoing radical cystectomy

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