Role of lymph node density in predicting survival of patients with lymph node metastases after radical cystectomy: A multi-institutional study
Role of lymph node density in predicting survival of patients with lymph node metastases after radical cystectomy: A multi-institutional study
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DOI：
10.1111/j.1442-2042.2008.02221.x
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发表时间：
2009-03-01
影响因子：
2.6
通讯作者：
Nonomura, Katsuya
中科院分区：
文献类型：
--
作者：
Osawa, Takahiro;Abe, Takashige;Nonomura, Katsuya
目的探讨不同临床病理参数对淋巴结阳性患者根治性膀胱切除术预后的影响。对1990年至2005年间接受根治性膀胱切除术的435例患者进行了一项回顾性多机构研究。其中病理淋巴结（LN）转移83例。83例患者中有60例纳入分析，其临床资料和随访资料均可获得。25例患者接受了辅助化疗，35例未接受辅助化疗。采用Cox比例风险模型确定以下临床病理参数对患者生存的影响：切除的LN数、阳性的LN数、LN密度（定义为阳性LN数除以切除的总LN数之比）和辅助化疗。术后存活患者的中位随访为41个月（范围4-138）。所有患者的中位生存时间为22个月（95%置信区间，15-42个月）。在多变量分析中，LN密度为25%或更低、辅助化疗和单纯尿路上皮癌是独立显著的生存预测因子。淋巴结密度预测淋巴结阳性膀胱癌患者的生存。
To evaluate the prognostic role of different clinico-pathological parameters in node-positive patients treated by radical cystectomy.A retrospective multi-institutional study of 435 patients who underwent radical cystectomy between 1990 and 2005 was carried out. Of them, pathological lymph node (LN) metastases were found in 83 patients. Sixty of these 83 patients, whose clinical information and follow-up data were available, were included in the analysis. Twenty-five patients had undergone adjuvant chemotherapy, whereas 35 had not. A Cox proportional hazards model was used to determine the impact of the following clinico-pathological parameters on patient survival: number of resected LNs, number of positive LNs, LN density (defined as the ratio of the number of positive LNs divided by the total number of resected LNs) and adjuvant chemotherapy.Median follow-up for surviving patients was 41 months (range 4-138) after surgery. The median survival time for all patients was 22 months (95% confidence interval, 15-42 months). At multivariate analysis, LN density of 25% or less, adjuvant chemotherapy and pure urothelial carcinoma were independently significant predictors of survival.Lymph node density predicts survival in patients with node-positive bladder cancer.