- The rate of lymph node dissection (LND) has increased over time in patients with nonmuscle invasive bladder cancer (NMIBC) undergoing radical cystectomy.
- An adequate LND (≥10 lymph nodes examined) is associated with improved OS in advanced stages of disease.
Why this matters
- The role of LND in nonmuscle invasive disease is unknown.
- 3226 patients (mean age, 65.3 years) with urothelial cell carcinoma who underwent radical cystectomy between 2004 and 2013.
- Funding: None disclosed.
- 73.8% of patients had high-grade disease, and 81.0% had cT1 disease.
- 55% of patients underwent adequate LND.
- During the study period, the rate of no LND decreased and the rate of adequate LND increased; the rate of inadequate LND remained stable.
- The mean lymph node yield was 5 for the inadequate cohort and 22 for the adequate LND cohort.
- In matched patients with vs without adequate LND:
- Median follow-up was 38.7 months vs 37.5 months.
- 5-year OS was 68.7% vs 60.6% (P<.01>
- Adequate LND showed a significant association with OS improvement (HR, 0.75; P<.01>
- OS improvement was observed for the cT1 stage (OR, 0.75; P<.01 but not the ctis or cta stages.>