Importance of the Number of Retreived LymphNodes During Cystectomy

Abstract

Purpose: To evaluate the effect of the number of dissected lymph nodes(LNs) during radical cystectomy on survival outcomes. Materials and Methods: Medical files of 211 patients who underwentcystectomy between 1996 and 2009 were retrospectively evaluated. Seventy-fourpatients were included in the study and divided into two groups regarding the median number of retrieved LNs (median number = 13); 36 patients in the 1st and 38 in the 2nd group. Radical cystectomy, urinary diversion, and pelvic LN dissection were done in all the patients. When necessary, adjuvantchemotherapy was applied. Kaplan-Meier survival analysis was performed tocompare survival outcomes of the groups. Results: Of 74 patients, 67 (90.5%) were men and 7 (9.5%) were women, with the mean age of 61.7 years (range, 39 to 83 years). Age distribution, pathologic stages, carcinoma in situ occurrence, adjuvant chemotherapyrates, LN involvement, and median follow-up period were similar in both groups. Mean dissected LNs number in the 1st and 2nd groups was 6.17 (range,1 to 12) and 21.6 (range, 13 to 41), respectively. Five-year estimated overall survival rates were 24.5% and 60.5% (P = .002) while five-year estimate ddisease-specific survival rates were 43.7% and 74.4% (P = .049), respectively. Conclusion: Although exact guidelines are not described, it seems that dissection of high number of LNs during radical cystectomy is crucial.

Keywords

• lymph nodes
• lymph node excision
• cystectomy
• prognosis
• transitional cell carcinoma