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J Urol: In non-muscular invasive bladder cancer, can lymphadenectomy improve the therapeutic effect of radical cystectomy?

 Last Update: 2021-12-03
 Source: Internet
 Author: User

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The American Urological Association (AUA), National Comprehensive Cancer Network (NCCN) and European Urology Association (EAU) guidelines recommend that during radical cystectomy (RC), patients with muscular invasive bladder cancer (MIBC) at least Lymph node dissection with standard template
.

This recommendation is supported by strong retrospective evidence

LND during MIBC radical cystectomy is oncologically beneficial.

Lymph node dissection (LND) in muscular invasive bladder cancer (MIBC) and radical cystectomy (RC) has been extensively studied, but in non-muscular invasive bladder cancer (NMIBC), the role of LND is still not understood Especially clear
.

Recently, researchers from the United States published an article in "J Urol", evaluating the relationship between LND and local pelvic recurrence-free survival (LPRS), cancer-specific survival (CSS), and overall survival (OS) during the RC period of NMIBC.
Relationship
.

The relationship between LND and local pelvic recurrence-free survival (LPRS), cancer-specific survival (CSS) and overall survival (OS) during the RC period of NMIBC was evaluated .
The relationship between LND and local pelvic recurrence-free survival ( The relationship between LPRS), cancer-specific survival (CSS) and overall survival (OS)

Researchers conducted a multi-institution retrospective study of NMIBC patients receiving RC treatment in three large tertiary referral centers
.

To optimize LPRS, CSS, and OS, the researchers determined thresholds for lymph node yield (LNY) and built a separate Cox regression model for each possible LNY threshold

A total of 1647 NMIBC patients received RC treatment, with a median LNY of 15 (quartiles of 9, 23)
.

The performance curve of the model is recommended to optimize the LNY of LPRS and CSS/OS to 10 and 20

Comparison of local pelvic recurrence-free survival

In summary, in the RC process of NMIBC, a greater degree of LND is related to the improvement of LPRS, CSS and OS
.

Therefore, their results support the inclusion of LND in the RC process of NMIBC patients, especially in patients with cTis or cT1 disease

In the RC process of NMIBC, a greater degree of LND is related to the improvement of LPRS, CSS and OS.

Original source:

Abhinav Khanna, Tanner Miest, Vidit Sharma et al.

Role of Lymphadenectomy During Radical Cystectomy for Non-muscle Invasive Bladder Cancer: Results From a Multi-Institutional Experience

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