Evidence map›Paper›PMID 40805235›Full record

ArticleCancers2025

Evaluating the Therapeutic Role of Lymph Node Dissection in Variant Subtype Bladder Cancer.

Syed Nahiyaan Rahman, Darryl T Martin, Kandala Keervani, Spencer James, Peter Humphrey, David Hesse, Wei Shen Tan, Sunil Patel, Jonathan Wright, Fady Ghali

Abstract read
In one paragraph

Article in Cancers, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Syed Nahiyaan RahmanDepartment of Urology, Yale University School of Medicine, New Haven, CT 06520, USA.
Darryl T MartinDepartment of Urology, Yale University School of Medicine, New Haven, CT 06520, USA.ORCID 0009-0007-9931-6273
Kandala KeervaniDepartment of Urology, Yale University School of Medicine, New Haven, CT 06520, USA.
Spencer JamesDepartment of Urology, University of Washington School of Medicine, Seattle, WA 98195, USA.
Peter HumphreyDepartment of Pathology, Yale University School of Medicine, New Haven, CT 06520, USA.
David HesseDepartment of Urology, Yale University School of Medicine, New Haven, CT 06520, USA.
Wei Shen TanDepartment of Urology, Yale University School of Medicine, New Haven, CT 06520, USA.
Sunil PatelJames Buchanan Brady Urological Institute, Johns Hopkins Medicine, Baltimore, MD 21201, USA.
Jonathan WrightDepartment of Pathology, Yale University School of Medicine, New Haven, CT 06520, USA.
Fady GhaliDepartment of Urology, Yale University School of Medicine, New Haven, CT 06520, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe importance of lymph node dissection (LND) at the time of radical cystectomy for urothelial carcinoma (UC) is widely accepted despite known risks. The therapeutic benefits of LND for variant subtype bladder cancer (VBC), a heterogenous and distinct set of diseases, are not well established. We aim to characterize the impact of LND on overall survival across VBC subtypes.

methodsThe National Cancer Database was queried for all cases of variant subtype bladder cancer managed with radical cystectomy between 2004 and 2020, using the International Classification of Disease-O-3 morphological codes. The cases were stratified by receipt of individual variant subtypes. The primary outcome was overall survival associated with pathologic nodal status and receipt of nodal dissection. A Kaplan-Meier analysis and Cox proportional hazards analysis were used for survival analyses.

resultsA total of 30,911 patients with VBC that were managed with radical cystectomy were included in our analysis. The pNx rates ranged from 33.1% in the micropapillary subtype, 42.2% in the sarcomatoid subtype, 68.4% in the squamous subtype, 48.9% in the adenocarcinoma subtype, and 56.2% in the neuroendocrine subtype. The median OS was higher in those that received a nodal dissection across subtypes but was statistically significant only for the squamous (71.0 [68.0 vs. 74.0] vs. 37.2 [33.6 vs. 40.9] months

conclusionsThe role of LND across VBC subtypes is not clearly defined and warrants further investigation to develop a more risk-adaptive approach. We demonstrate heterogeneity with respect to the OS benefit associated with LND at the time of surgery. Among certain VBC subtypes, LND may not offer a significant therapeutic benefit, while LND in squamous and adenocarcinoma VBCs is correlated with improved survival.

Indexed as

cystectomynode dissectionurothelialvariant

Identifiers

PMID40805235
PMCPMC12346734

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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.