Extended lymphadenectomy in bladder cancer
- 1 September 2010
- journal article
- review article
- Published by Ovid Technologies (Wolters Kluwer Health) in Current Opinion in Urology
- Vol. 20 (5), 414-420
- https://doi.org/10.1097/mou.0b013e32833c9194
Abstract
Radical cystectomy with pelvic lymph node dissection (PLND) is the preferred treatment for invasive bladder cancer. It not only results in the best disease-free term survival rates, but also provides the most accurate disease staging and most effective local symptom control. Recent investigations have demonstrated a clinical benefit to performance of an extended PLND, including all lymphatic tissue to the level of the aortic bifurcation. This review will summarize recent findings regarding the clinical benefits of radical cystectomy with extended lymphadenectomy, and will also examine the latest surgical techniques for optimizing the performance of this technically demanding procedure. Recent studies have demonstrated increased recurrence-free survival and overall survival rates in patients undergoing radical cystectomy with extended PLND, even in cases of pathologically lymph node negative disease. The growing use of minimally invasive techniques has prompted interest in robotic radical cystectomy and extended PLND, and recent reports have demonstrated the feasibility of this technique. The standardization of extended PLND templates has also been a focus of contemporary research. Contemporary research strongly suggests that all patients undergoing radical cystectomy for bladder cancer should undergo concomitant extended PLND. Randomized trials are still needed to confirm the benefits of extended over 'standard' PLND, and to clarify which patients may receive the greatest benefit from this procedure.Keywords
This publication has 42 references indexed in Scilit:
- Prospective Randomized Controlled Trial of Robotic versus Open Radical Cystectomy for Bladder Cancer: Perioperative and Pathologic ResultsEuropean Urology, 2010
- Robotic Anterior Pelvic Exenteration for Bladder Cancer in the Female: Outcomes and Comparisons to Their Male CounterpartsJournal of Laparoendoscopic & Advanced Surgical Techniques, 2009
- The lymph node yield during robot‐assisted radical cystectomyBJU International, 2008
- Robotic-Assisted Laparoscopic Radical CystoprostatectomyEuropean Urology, 2008
- Presentation, location and overall survival of pelvic recurrence after radical cystectomy for transitional cell carcinoma of the bladderBJU International, 2007
- Cancer Statistics, 2007CA: A Cancer Journal for Clinicians, 2007
- Lymphadenectomy for invasive bladder cancer. II. technical aspects and prognostic factorsBJU International, 2006
- Correlation between clinical and pathological staging in a series of radical cystectomies for bladder carcinomaBJU International, 2005
- Standardization of Radical Cystectomy and Pelvic Lymph Node Dissection for Bladder Cancer: A Collaborative Group ReportJournal of Urology, 2004
- EDITORIAL COMMENTJournal of Urology, 2004