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01-04-2013 | Urologic Oncology

External Validation of Extranodal Extension and Lymph Node Density as Predictors of Survival in Node-positive Bladder Cancer after Radical Cystectomy

Authors: Alexandra Masson-Lecomte, MD, Dimitri Vordos, MD, Andras Hoznek, MD, René Yiou, PhD, Yves Allory, PhD, Claude C. Abbou, PhD, Alexandre de la Taille, PhD, Laurent Salomon, PhD

Published in: Annals of Surgical Oncology | Issue 4/2013

Abstract

Background

Prognostic factors in pathologic node-positive patients after radical cystectomy are debated. Extranodal extension (ENE) and lymph node density (LND) are strong predictors of survival. The aim of this study was to assess factors predictive of survival and to evaluate the prognostic significance of the tumor, node, metastasis staging system (TNM) nodal classification in a retrospective cohort of node-positive bladder cancers after radical cystectomy.

Methods

We retrospectively reviewed the data of 75 patients with node-positive bladder cancer after radical cystectomy. Node pathological examination was performed by two experienced uropathologists. Cox regression analysis was performed to identify factors predictive of progression.

Results

The median number of removed lymph node was 18 (range 3–49). The median number of positive lymph nodes was 3 (range 1–35). Overall progression-free and cancer-specific survival were 5 and 12 %. In multivariate analysis, ENE, LND with a 20 % cutoff, and adjuvant chemotherapy were independent predictors of progression-free survival (p = 0.007, 0.006, <0.0001). Neither the 2002 nor the 2009 TNM nodal classification was associated with recurrence.

Conclusions

ENE and LND are strong predictors of clinical outcome in patients with node-positive bladder cancer treated by cystectomy. The actual TNM classification could probably be improved using these criteria, allowing better prognostic classification of node-positive bladder cancer after radical cystectomy.

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Title: External Validation of Extranodal Extension and Lymph Node Density as Predictors of Survival in Node-positive Bladder Cancer after Radical Cystectomy
Authors: Alexandra Masson-Lecomte, MD
Dimitri Vordos, MD
Andras Hoznek, MD
René Yiou, PhD
Yves Allory, PhD
Claude C. Abbou, PhD
Alexandre de la Taille, PhD
Laurent Salomon, PhD
Publication date: 01-04-2013
Publisher: Springer-Verlag
Published in: Annals of Surgical Oncology / Issue 4/2013
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI: https://doi.org/10.1245/s10434-012-2753-0

Keynote webinar | Spotlight on medication adherence

Springer Medicine

External Validation of Extranodal Extension and Lymph Node Density as Predictors of Survival in Node-positive Bladder Cancer after Radical Cystectomy

Abstract

Background

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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