Lymphadenectomy for bladder cancer at the time of radical cystectomy

Derya Tilki, Maurizio Brausi, Renzo Colombo, Christopher P. Evans, Yves Fradet, Hans Martin Fritsche, Seth P. Lerner, Arthur I Sagalowsky, Shahrokh F. Shariat, Bernard H. Bochner

Research output: Contribution to journalArticle

36 Citations (Scopus)

Abstract

Context Although the importance of lymphadenectomy during radical cystectomy (RC) in high-risk non-muscle-invasive and muscle-invasive bladder cancer (BCa) is well accepted, the optimal extent of lymphadenectomy, number of lymph nodes (LNs) to be retrieved, and prognostic and therapeutic role of lymphadenectomy remain debated issues. Objective In this review, we summarize the existing data on the value of lymphadenectomy for staging and outcome of BCa patients undergoing RC and lymphadenectomy. Evidence acquisition A systematic Medline/PubMed literature search of peer-reviewed scientific articles published from 1998 and 2012, concerning the role of lymphadenectomy in BCa patients, was carried out. The terms and permutations used were lymphadenectomy, bladder cancer/carcinoma, urothelial carcinomas, radical cystectomy, lymph node metastasis, lymph node dissection, bladder, recurrence, and survival. Selective older articles were included. Evidence synthesis Bilateral pelvic lymphadenectomy is an integral part of RC for BCa. The literature regarding the role of lymphadenectomy in BCa patients in general is retrospective, nonstandardized, and of low-level quality in regard to evidence. Prospective randomized trials designed to define the optimal template of lymphadenectomy and its impact on oncologic outcome are advocated. Some of these studies are ongoing, and their completion and analyses are necessary to resolve controversies. Conclusions Many consistent and concordant observations, although of low level of evidence, document that the extent of lymphadenectomy may influence disease-free survival after RC independent of the status of LNs and the pathologic stage of BCa. Lymphadenectomy standardization at the time of RC to create evidence-based guidelines is essential for further improvement of surgical quality and BCa patient survival.

Original languageEnglish (US)
Pages (from-to)266-276
Number of pages11
JournalEuropean Urology
Volume64
Issue number2
DOIs
StatePublished - Aug 2013

Fingerprint

Cystectomy
Lymph Node Excision
Urinary Bladder Neoplasms
Lymph Nodes
Carcinoma
Survival
Quality Improvement
PubMed
Disease-Free Survival
Urinary Bladder

Keywords

  • Bladder cancer
  • Lymphadenectomy
  • Systematic review

ASJC Scopus subject areas

  • Urology

Cite this

Tilki, D., Brausi, M., Colombo, R., Evans, C. P., Fradet, Y., Fritsche, H. M., ... Bochner, B. H. (2013). Lymphadenectomy for bladder cancer at the time of radical cystectomy. European Urology, 64(2), 266-276. https://doi.org/10.1016/j.eururo.2013.04.036

Lymphadenectomy for bladder cancer at the time of radical cystectomy. / Tilki, Derya; Brausi, Maurizio; Colombo, Renzo; Evans, Christopher P.; Fradet, Yves; Fritsche, Hans Martin; Lerner, Seth P.; Sagalowsky, Arthur I; Shariat, Shahrokh F.; Bochner, Bernard H.

In: European Urology, Vol. 64, No. 2, 08.2013, p. 266-276.

Research output: Contribution to journalArticle

Tilki, D, Brausi, M, Colombo, R, Evans, CP, Fradet, Y, Fritsche, HM, Lerner, SP, Sagalowsky, AI, Shariat, SF & Bochner, BH 2013, 'Lymphadenectomy for bladder cancer at the time of radical cystectomy', European Urology, vol. 64, no. 2, pp. 266-276. https://doi.org/10.1016/j.eururo.2013.04.036
Tilki D, Brausi M, Colombo R, Evans CP, Fradet Y, Fritsche HM et al. Lymphadenectomy for bladder cancer at the time of radical cystectomy. European Urology. 2013 Aug;64(2):266-276. https://doi.org/10.1016/j.eururo.2013.04.036
Tilki, Derya ; Brausi, Maurizio ; Colombo, Renzo ; Evans, Christopher P. ; Fradet, Yves ; Fritsche, Hans Martin ; Lerner, Seth P. ; Sagalowsky, Arthur I ; Shariat, Shahrokh F. ; Bochner, Bernard H. / Lymphadenectomy for bladder cancer at the time of radical cystectomy. In: European Urology. 2013 ; Vol. 64, No. 2. pp. 266-276.
@article{b67c328dcbf34b2b81c9a1d208bbec24,
title = "Lymphadenectomy for bladder cancer at the time of radical cystectomy",
abstract = "Context Although the importance of lymphadenectomy during radical cystectomy (RC) in high-risk non-muscle-invasive and muscle-invasive bladder cancer (BCa) is well accepted, the optimal extent of lymphadenectomy, number of lymph nodes (LNs) to be retrieved, and prognostic and therapeutic role of lymphadenectomy remain debated issues. Objective In this review, we summarize the existing data on the value of lymphadenectomy for staging and outcome of BCa patients undergoing RC and lymphadenectomy. Evidence acquisition A systematic Medline/PubMed literature search of peer-reviewed scientific articles published from 1998 and 2012, concerning the role of lymphadenectomy in BCa patients, was carried out. The terms and permutations used were lymphadenectomy, bladder cancer/carcinoma, urothelial carcinomas, radical cystectomy, lymph node metastasis, lymph node dissection, bladder, recurrence, and survival. Selective older articles were included. Evidence synthesis Bilateral pelvic lymphadenectomy is an integral part of RC for BCa. The literature regarding the role of lymphadenectomy in BCa patients in general is retrospective, nonstandardized, and of low-level quality in regard to evidence. Prospective randomized trials designed to define the optimal template of lymphadenectomy and its impact on oncologic outcome are advocated. Some of these studies are ongoing, and their completion and analyses are necessary to resolve controversies. Conclusions Many consistent and concordant observations, although of low level of evidence, document that the extent of lymphadenectomy may influence disease-free survival after RC independent of the status of LNs and the pathologic stage of BCa. Lymphadenectomy standardization at the time of RC to create evidence-based guidelines is essential for further improvement of surgical quality and BCa patient survival.",
keywords = "Bladder cancer, Lymphadenectomy, Systematic review",
author = "Derya Tilki and Maurizio Brausi and Renzo Colombo and Evans, {Christopher P.} and Yves Fradet and Fritsche, {Hans Martin} and Lerner, {Seth P.} and Sagalowsky, {Arthur I} and Shariat, {Shahrokh F.} and Bochner, {Bernard H.}",
year = "2013",
month = "8",
doi = "10.1016/j.eururo.2013.04.036",
language = "English (US)",
volume = "64",
pages = "266--276",
journal = "European Urology",
issn = "0302-2838",
publisher = "Elsevier",
number = "2",

}

TY - JOUR

T1 - Lymphadenectomy for bladder cancer at the time of radical cystectomy

AU - Tilki, Derya

AU - Brausi, Maurizio

AU - Colombo, Renzo

AU - Evans, Christopher P.

AU - Fradet, Yves

AU - Fritsche, Hans Martin

AU - Lerner, Seth P.

AU - Sagalowsky, Arthur I

AU - Shariat, Shahrokh F.

AU - Bochner, Bernard H.

PY - 2013/8

Y1 - 2013/8

N2 - Context Although the importance of lymphadenectomy during radical cystectomy (RC) in high-risk non-muscle-invasive and muscle-invasive bladder cancer (BCa) is well accepted, the optimal extent of lymphadenectomy, number of lymph nodes (LNs) to be retrieved, and prognostic and therapeutic role of lymphadenectomy remain debated issues. Objective In this review, we summarize the existing data on the value of lymphadenectomy for staging and outcome of BCa patients undergoing RC and lymphadenectomy. Evidence acquisition A systematic Medline/PubMed literature search of peer-reviewed scientific articles published from 1998 and 2012, concerning the role of lymphadenectomy in BCa patients, was carried out. The terms and permutations used were lymphadenectomy, bladder cancer/carcinoma, urothelial carcinomas, radical cystectomy, lymph node metastasis, lymph node dissection, bladder, recurrence, and survival. Selective older articles were included. Evidence synthesis Bilateral pelvic lymphadenectomy is an integral part of RC for BCa. The literature regarding the role of lymphadenectomy in BCa patients in general is retrospective, nonstandardized, and of low-level quality in regard to evidence. Prospective randomized trials designed to define the optimal template of lymphadenectomy and its impact on oncologic outcome are advocated. Some of these studies are ongoing, and their completion and analyses are necessary to resolve controversies. Conclusions Many consistent and concordant observations, although of low level of evidence, document that the extent of lymphadenectomy may influence disease-free survival after RC independent of the status of LNs and the pathologic stage of BCa. Lymphadenectomy standardization at the time of RC to create evidence-based guidelines is essential for further improvement of surgical quality and BCa patient survival.

AB - Context Although the importance of lymphadenectomy during radical cystectomy (RC) in high-risk non-muscle-invasive and muscle-invasive bladder cancer (BCa) is well accepted, the optimal extent of lymphadenectomy, number of lymph nodes (LNs) to be retrieved, and prognostic and therapeutic role of lymphadenectomy remain debated issues. Objective In this review, we summarize the existing data on the value of lymphadenectomy for staging and outcome of BCa patients undergoing RC and lymphadenectomy. Evidence acquisition A systematic Medline/PubMed literature search of peer-reviewed scientific articles published from 1998 and 2012, concerning the role of lymphadenectomy in BCa patients, was carried out. The terms and permutations used were lymphadenectomy, bladder cancer/carcinoma, urothelial carcinomas, radical cystectomy, lymph node metastasis, lymph node dissection, bladder, recurrence, and survival. Selective older articles were included. Evidence synthesis Bilateral pelvic lymphadenectomy is an integral part of RC for BCa. The literature regarding the role of lymphadenectomy in BCa patients in general is retrospective, nonstandardized, and of low-level quality in regard to evidence. Prospective randomized trials designed to define the optimal template of lymphadenectomy and its impact on oncologic outcome are advocated. Some of these studies are ongoing, and their completion and analyses are necessary to resolve controversies. Conclusions Many consistent and concordant observations, although of low level of evidence, document that the extent of lymphadenectomy may influence disease-free survival after RC independent of the status of LNs and the pathologic stage of BCa. Lymphadenectomy standardization at the time of RC to create evidence-based guidelines is essential for further improvement of surgical quality and BCa patient survival.

KW - Bladder cancer

KW - Lymphadenectomy

KW - Systematic review

UR - http://www.scopus.com/inward/record.url?scp=84879920705&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84879920705&partnerID=8YFLogxK

U2 - 10.1016/j.eururo.2013.04.036

DO - 10.1016/j.eururo.2013.04.036

M3 - Article

C2 - 23648149

AN - SCOPUS:84879920705

VL - 64

SP - 266

EP - 276

JO - European Urology

JF - European Urology

SN - 0302-2838

IS - 2

ER -