Regional Lymph Node Metastasis From Bladder Cancer

Abstract

The prognosis for patients with bladder cancer metastatic to regional lymph nodes is dismal and only minimally altered by current treatment modalities. The 5-yr survival rate after radical cystectomy for 134 bladder cancer patients with positive regional lymph nodes was only 7%; 82% of the patients died of bladder cancer. Stratification of patients into groups with varying extent of nodal disease showed a correlation between the level of nodal involvement and the interval to recurrence. While 38% of the patients died of distant disease alone, 25% had only pelvic recurrence, indicating a possible therapeutic effect of a systematic bilateral pelvic lymphadenectomy and implicating extrapelvic disease as a major determinant of patient survival.