ArticleUrologic oncology2024
Pelvic lymphadenectomy: Evaluating nodal stage migration and will rogers effect in bladder cancer.
Article in Urologic oncology, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers, 1 of them a synthesis that pooled it.
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Who cites it
8 citing papers in PubMed, 1 synthesis or guideline pooled it, 9 citations in OpenAlex.
- Comparison of extended and standard lymph node dissection in radical cystectomy for urothelial bladder cancer: a systematic review and meta-analysis.World journal of urology · 2025Pooled it
- Standard or Extended Lymphadenectomy for Muscle-Invasive Bladder Cancer.The New England journal of medicine · 2024Trial
- Lymph node dissection during cystectomy for non-muscle-invasive bladder cancer: A systematic review.BJUI compass · 2026Review
- Prognostic significance of lymph node yield in pelvic lymph node dissection for bladder cancer: population-based study.World journal of surgical oncology · 2025Article
- Article
- Bladder sparing management for muscle-invasive bladder cancer after a complete clinical response: ready for prime time?-a narrative review.Translational cancer research · 2024Review
- Adequate pelvic lymph node dissection during radical cystectomy for muscle-invasive carcinoma urinary bladder: A systematic review and meta-analysis of randomized controlled trials comparing extended and limited lymph node dissection.Indian journal of urology : IJU : journal of the Urological Society of IndiaReview
- Standard vs extended lymphadenectomy for muscle invasive bladder cancer.Bladder cancer (Amsterdam, Netherlands)Article
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Authors and funding
12 authors at 1 institution in 1 country.
Funding
Abstract
introductionPelvic lymphadenectomy (PLND) alongside radical cystectomy (RC), provides crucial diagnostic and therapeutic value in patients with bladder cancer. With the advent of neoadjuvant chemotherapy and prospective data supporting standard PLND, controversy remains regarding the optimal PLND extent and patient selection. Nearly 40% of patients may not receive adequate PLND, even though 25% of patients have positive lymph nodes (LN) at time of RC. We hypothesized that PLND still remains an important facet of bladder cancer treatment. To clarify the prognostic importance of nodal yield, we performed a retrospective investigation of a heterogenous population (pTanyNx/0M0) of patients undergoing RC.
methodsFrom the Surveillance, Epidemiology, and End Results (SEER) program, we identified pTanyNx/0M0 bladder cancer patients undergoing RC from 2004 to 2015. Kaplan Meier curves and Cox proportional hazards models assessed cancer-specific survival. Patients were analyzed with PLND performed as the primary covariate. Survival analysis then stratified patients undergoing PLND by LN yield, both as a continuous and categorial variable (≤10, 11-20, 21-30, and >30), and T stage.
resultsThe final cohort included pTanyNx/0M0 patients with urothelial bladder cancer (n = 12,096); median follow up was 39 (IQR: 17-77) months. PLND was performed in 81.45% of patients with a median LN yield of 14 (IQR: 7-23). Most commonly, patients had T2 disease (44.68%). After controlling for age and T stage, patients receiving PLND had improved CSS (HR = 0.56, [95% CI: 0.51-0.62]) compared to those that did not receive PLND. When grouping patients by LN yield, survival improved in a "dose dependent" manner (>30 LN: HR = 0.76, [95% CI: 0.66-0.87]). We noted similar results when stratifying patients into non-muscle-invasive (NMIBC) and muscle-invasive bladder cancer (MIBC).
conclusionsIn a large contemporary series of pTanyNx/0M0 bladder cancer patients, we found a significant oncologic benefit to PLND. Higher LN yield correlated to improved CSS in non-muscle-invasive and muscle-invasive disease. Our data support the possibility of occult micrometastasis even in non-muscle-invasive disease. Additionally, in light of recent advances in adjuvant immunotherapy, our results emphasize the importance of adequate nodal yield for accurate staging and optimal treatment.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.