In:
BJU International, Wiley, Vol. 113, No. 4 ( 2014-04), p. 554-560
Abstract:
To analyse the long‐term outcomes of patients with lymph node ( LN )‐positive bladder cancer, who did not receive any adjuvant therapy after radical cystectomy ( RC ) and extended pelvic lymph node dissection ( ePLND ). Patients and Methods We conducted a retrospective, combined cohort analysis based on two prospectively maintained cystectomy databases from the U niversity of S outhern C alifornia and the U niversity of B ern. Eligible patients underwent RC with ePLND for cN0M0 disease but were found to have LN ‐positive disease. No patient had neoadjuvant therapy, and all had negative surgical margins. Kaplan– M eier plots were used to estimate recurrence‐free survival ( RFS ) and overall survival ( OS ). Subgroup comparisons were performed using log‐rank tests, and multivariable analysis was based on C ox proportional hazard models. Results Of 521 patients with LN ‐positive disease, 251 (48%) never received adjuvant therapy. Although the pathological stage distribution was similar, the 251 patients who did not receive adjuvant therapy were older and had both fewer total and positive LNs than those who underwent adjuvant therapy. The median RFS for patients treated with RC alone was 1.6 years. Recurrences mainly occurred 〈 2 years after RC , resulting in 5‐ and 10‐year RFS rates of 32 and 26%, respectively. Pathological T stage, the total number of LNs and the number of positive LNs detected were independent predictors of RFS and OS . Conclusions In this study, 25% of patients with documented LN metastases who did not receive adjuvant therapy were cured with RC and ePLND ; however, a few relapses may occur later than 3 years. Predictors of survival were pathological T stage, the number of total LNs and the number of positive LNs identified.
Type of Medium:
Online Resource
ISSN:
1464-4096
,
1464-410X
DOI:
10.1111/bju.2014.113.issue-4
Language:
English
Publisher:
Wiley
Publication Date:
2014
detail.hit.zdb_id:
2019983-1