Lymph node assessment and lymphadenectomy in bladder cancer

Sharir, Sharon; Fleshner, Neil

doi:10.1002/jso.21253

Cited by 22 publications

(22 citation statements)

References 71 publications

(186 reference statements)

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“…The histopathological results and the extent of lymph node removal have significance as prognostic criteria and thus as indicators for adjuvant therapy [8,19,28].…”

Section: Factors That Affect the Number Of Removed Lymph Nodes In Cysmentioning

confidence: 99%

“…Standard pelvic lymph node dissection is described removing the lymph nodes including bifurcation of the common iliac vessels superiorly and the genitofemoral nerve laterally. And the limit of inferior and medial boundaries includes the obturator nerve, bladder, and internal iliac vessels medially and the endopelvic fascia, circumflex iliac veins, and Cloquet's node inferiorly [5][6][7][8] (Figure 1). For the standard pathological evaluation of lymph nodes to detect the presence of tumor cell after surgery, formalin fixation with hematoxylin and eosin (H&E) staining of 5-μm thick sections of each node is done.…”

Section: Introductionmentioning

confidence: 99%

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Lymphadenectomy in Muscle Invasive Bladder Cancer

Horsanalı¹,

Ozer²

2017

Bladder Cancer - Management of NMI and Muscle-Invasive Cancer

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Bladder cancer is the second most common genitourinary malignancy with urothelial cancer comprising nearly 90% of primary bladder tumors. Urothelial carcinoma of the urinary bladder is the fifth most common malignancy in the United States, with an estimated 76,960 new cases and 163,900 deaths in 2016. Radical cystectomy with lymph node dissection remains the standard treatment for patients with muscle-invasive urothelial carcinoma of the bladder, and also for nonmuscle-invasive disease, refractory to intravesical therapy. The current approaches to pelvic lymph node dissections are based on the removal of lymph nodes most commonly harboring metastatic disease, notably the external iliac, obturator, and hypogastric lymph nodes. The boundaries for a standard pelvic lymph node dissection generally include the bifurcation of the common iliac vessels superiorly and the genitofemoral nerve laterally. Extended pelvic lymph node includes the removal of lymph nodes between the bifurcation of the common iliac vessels and the level of the aortic bifurcation, sometimes including distal aortic and caval nodes up to the level of the inferior mesenteric artery, as well as presacral nodes. Extended and superextended dissection has been reported to be associated with superior survival outcome.

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“…The histopathological results and the extent of lymph node removal have significance as prognostic criteria and thus as indicators for adjuvant therapy [8,19,28].…”

Section: Factors That Affect the Number Of Removed Lymph Nodes In Cysmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Lymphadenectomy in Muscle Invasive Bladder Cancer

Horsanalı¹,

Ozer²

2017

Bladder Cancer - Management of NMI and Muscle-Invasive Cancer

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“…Lymphatic trunks leading from the pelvic LNs subsequently drain into more proximal common iliac LNs and then to aortocaval LNs [2, 3]. Skip lesions have been reported, but their rarity suggests that the pelvic LNs are the primary landing site and that metastasis occurs in an orderly progression [2, 4–8]. …”

Section: Lymphatic Drainage Of the Bladdermentioning

confidence: 99%

Lymphadenectomy in Management of Invasive Bladder Cancer

Youssef

Raj

2011

International Journal of Surgical Oncology

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Radical cystectomy with pelvic lymphadenectomy represents the gold standard for treatment of muscle-invasive bladder cancer. Extent of the lymph node dissection and lymph node involvement during radical cystectomy are the most powerful prognostic factors associated with poor oncological outcome. However, the optimal boundaries of the lymph node dissection during a radical cystectomy are controversial. The published literature based mostly on retrospective studies suggests that increasing the number of nodes excised may have therapeutic and diagnostic benefits without significantly increasing the surgical morbidity. These conclusions are, however, influenced by selection and surgeon biases, inconsistencies in the quality of the surgery, and node count variability. In this paper, we establish the current understanding about the utility of lymphadenectomy during a radical cystectomy for muscle-invasive bladder cancer.

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“…Ob dieses Ausmaß ausreichend ist, oder ob eine erweiterte Lymphadenektomie vonnöten ist, muss in weiteren Studien nachgewiesen werden. Hier bestehen kontroverse Ansichten[71]. Dennoch ist die erweiterte Lymphadenektomie zu empfehlen, da trotz strittiger Datenlage die Heilungsrate, sowie das rezidivfreie Überleben positiv beeinflusst wird[36,72,73].…”

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