The role of pelvic lymph node dissection in the management of invasive bladder cancer
Waters, William Bedford × Bassi, Pierfrancesco Ohi, Yoshitada Ohshima, Shinichi Van Poppel, Hendrik Smith, Joseph A. Tjima, Atsushi #
Urologic oncology vol:4 issue:4-5 pages:168-171
Regional pelvic lymph nodes are often the first site of metastatic disease in patients with invasive transitional cell carcinoma of the bladder. The presence of lymph node metastasis has profound adverse prognostic implications but long term survival is seen in a limited number of patients with histologically positive nodes removed at the time of radical cystectomy. Nonetheless, the value of pelvic lymph node dissection as a staging versus a therapeutic maneuver has been a subject of debate. The development of cytotoxic chemotherapeutic agents with proven efficacy against bladder cancer changes some of the rationale supporting various attitudes toward lymph node dissection. Moreover, non-operative or less invasive methods for assessing or removing pelvic lymph nodes are now available and may also influence patient management.