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  • To determine whether the number of lymph nodes (LNs) examined is associated with outcomes in patients without nodal metastasis after radical cystectomy (RC). We retrospectively analyzed data from 4,188 patients treated at 12 centers with RC and pelvic lymphadenectomy without neo-adjuvant chemotherapy for urothelial carcinoma of the bladder (UCB). Outcomes of patients without LN metastasis (n = 3,088) were examined according to the LN yield analyzed as continuous variable, tertiles, and using the cutoffs of a parts per thousand yen9 and a parts per thousand yen20. The median nodal yield was 18 (range 1-123; IQR:20). A total of 2591 (84 %) and 1445 (47 %) patients had a LN yield a parts per thousand yen9 and a parts per thousand yen20, respectively. Median follow-up was 47 months (IQR:70). In multivariable analyses that adjusted for the standard clinicopathologic factors, higher LN yield was associated with a decreased risk of disease recurrence (continuous: HR = 0.996, p = 0.05; 3rd vs 1st tertile: HR = 0.853, p = 0.048; cutoff a parts per thousand yen20: HR = 0.851, p = 0.032). In the subgroups of patients with muscle-invasive UCB or those with a parts per thousand yen9 LN removed, LN yield was not associated with outcomes (p values > 0.05). In this large multicenter cohort of patients with node-negative UCB, higher nodal yield improved recurrence-free survival when all patients were analyzed. Patients with a high LN yield (a parts per thousand yen20 LN removed or 3rd tertile) had the largest benefit. The lack of prognostic significance of LN yield in patients with muscle-invasive UCB or those stratified by 9 LNs removed suggests that this effect is weak. Further prospective studies are needed to help identify preoperatively the optimal template for each patient.
  • To determine whether the number of lymph nodes (LNs) examined is associated with outcomes in patients without nodal metastasis after radical cystectomy (RC). We retrospectively analyzed data from 4,188 patients treated at 12 centers with RC and pelvic lymphadenectomy without neo-adjuvant chemotherapy for urothelial carcinoma of the bladder (UCB). Outcomes of patients without LN metastasis (n = 3,088) were examined according to the LN yield analyzed as continuous variable, tertiles, and using the cutoffs of a parts per thousand yen9 and a parts per thousand yen20. The median nodal yield was 18 (range 1-123; IQR:20). A total of 2591 (84 %) and 1445 (47 %) patients had a LN yield a parts per thousand yen9 and a parts per thousand yen20, respectively. Median follow-up was 47 months (IQR:70). In multivariable analyses that adjusted for the standard clinicopathologic factors, higher LN yield was associated with a decreased risk of disease recurrence (continuous: HR = 0.996, p = 0.05; 3rd vs 1st tertile: HR = 0.853, p = 0.048; cutoff a parts per thousand yen20: HR = 0.851, p = 0.032). In the subgroups of patients with muscle-invasive UCB or those with a parts per thousand yen9 LN removed, LN yield was not associated with outcomes (p values > 0.05). In this large multicenter cohort of patients with node-negative UCB, higher nodal yield improved recurrence-free survival when all patients were analyzed. Patients with a high LN yield (a parts per thousand yen20 LN removed or 3rd tertile) had the largest benefit. The lack of prognostic significance of LN yield in patients with muscle-invasive UCB or those stratified by 9 LNs removed suggests that this effect is weak. Further prospective studies are needed to help identify preoperatively the optimal template for each patient. (en)
Title
  • Does increasing the nodal yield improve outcomes in patients without nodal metastasis at radical cystectomy?
  • Does increasing the nodal yield improve outcomes in patients without nodal metastasis at radical cystectomy? (en)
skos:prefLabel
  • Does increasing the nodal yield improve outcomes in patients without nodal metastasis at radical cystectomy?
  • Does increasing the nodal yield improve outcomes in patients without nodal metastasis at radical cystectomy? (en)
skos:notation
  • RIV/00064203:_____/12:8135!RIV13-MZ0-00064203
http://linked.open...avai/predkladatel
http://linked.open...avai/riv/aktivita
http://linked.open...avai/riv/aktivity
  • I
http://linked.open...iv/cisloPeriodika
  • 6
http://linked.open...vai/riv/dodaniDat
http://linked.open...aciTvurceVysledku
http://linked.open.../riv/druhVysledku
http://linked.open...iv/duvernostUdaju
http://linked.open...titaPredkladatele
http://linked.open...dnocenehoVysledku
  • 131845
http://linked.open...ai/riv/idVysledku
  • RIV/00064203:_____/12:8135
http://linked.open...riv/jazykVysledku
http://linked.open.../riv/klicovaSlova
  • Bladder cancer; Survival; Recurrence; Radical cystectomy; Lymph node; Transitional cell carcinoma; invasive bladder-cancer; transitional-cell carcinoma; lymph-nodes; pelvic lymphadenectomy; prostate-cancer; dissection; standardization; prognosis; survival; number (en)
http://linked.open.../riv/klicoveSlovo
http://linked.open...odStatuVydavatele
  • US - Spojené státy americké
http://linked.open...ontrolniKodProRIV
  • [49D3EC57795C]
http://linked.open...i/riv/nazevZdroje
  • World Journal of Urology
http://linked.open...in/vavai/riv/obor
http://linked.open...ichTvurcuVysledku
http://linked.open...cetTvurcuVysledku
http://linked.open...UplatneniVysledku
http://linked.open...v/svazekPeriodika
  • 30
http://linked.open...iv/tvurceVysledku
  • Babjuk, Marek
  • Bastian, PJ
  • Chun, FK
  • Daneshmand, S.
  • Fitzgerald, J. P.
  • Fradet, Y.
  • Fritsche, H. M.
  • Green, D. A.
  • Hansen, J.
  • Kamat, A. M.
  • Karakiewicz, PI
  • Kassouf, W.
  • Lotan, Y.
  • Merseburger, AS
  • Novara, G.
  • Rink, M.
  • Scherr, DS
  • Shariat, SF
  • Svatek, RS
  • Tagawa, ST
  • Tilki, D.
  • Trinh, QD
  • Volkmer, B. G.
  • Xylinas, E.
http://linked.open...ain/vavai/riv/wos
  • 000311793500012
issn
  • 0724-4983
number of pages
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