Radical cystectomy for bladder cancer today - A homogeneous series without neoadjuvant therapy
Radical cystectomy for bladder cancer today - A homogeneous series without neoadjuvant therapy
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DOI：
10.1200/jco.2003.05.101
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发表时间：
2003-02-15
影响因子：
45.3
通讯作者：
Studer, UE
中科院分区：
文献类型：
--
作者：
Madersbacher, S;Hochreiter, W;Studer, UE
目的：探讨盆腔淋巴结清扫术和根治性膀胱移行细胞癌的复发和总生存率，盆腔复发，转移模式在一个均匀group.Patients和方法：一个连续的一系列患者进行盆腔淋巴结清扫术和根治性膀胱癌1985年和2000年之间进行了分析。所有患者术前均为NO、MO分期，无患者接受新辅助放化疗。1997年肿瘤淋巴结转移系统，复发/总生存率，转移patterns.Results的基础上的病理特征：五百七例（年龄66 +/- 12岁），平均随访时间为45个月（范围，0.1至176个月）进行了分析。器官局限性淋巴结阴性肿瘤患者（n = 217;小于或等于pT 2，pNO）的5年无复发率和总生存率分别为73%和62%，而非器官局限性淋巴结阴性肿瘤患者（n = 166; > pT 2，pN 0）的5年无复发率和总生存率分别为56%和49%。在124例（24%）具有5年无复发（33%）或总生存率（26%）的患者中发现了阳性淋巴结。在3%的器官局限性肿瘤患者中观察到孤立的局部复发（：5 pT 2，pN 0），11%的非器官局限性肿瘤（小于或等于pT 2，pN 0），13%的淋巴结阳性（任何pT，pN+）。25%的器官局限性肿瘤，370%的非器官局限性肿瘤，和51%的患者与阳性lymph nodes.Conclusion：尽管负术前分期，盆腔淋巴结切除术和膀胱癌的膀胱癌显示了高比例的未被怀疑的淋巴结转移（24%），有25%的长期生存的机会。该手术还确保了即使在淋巴结阳性患者中盆腔复发率也较低，并且局部晚期癌症患者的5年无复发生存率为56%。(C)2003年，美国临床肿瘤学会。
Purpose : To investigate the effect of pelvic lymph node dissection and radical cystectomy for transitional cell cancer of the bladder on recurrence-free and overall survival, pelvic recurrences, and metastatic patterns in a homogeneous group.Patients and Methods: A consecutive series of patients undergoing pelvic lymphadenectomy and radical cystectomy between 1985 and 2000 was analyzed. All patients were staged NO, MO preoperatively, and no patient received neoadjuvant radio/chemotherapy. Pathologic characteristics based on the 1997 tumor-node-metastasis system, recurrence-free/overall survival, and metastatic patterns were determined.Results: Five hundred seven patients (age 66 +/- 12 years) with a mean follow-up time of 45 months (range, 0.1 to 176 months) were analyzed. Five-year recurrence-free and overall survival were, respectively, 73% and 62% for patients with organ-confined, lymph node-negative tumors (n = 217; less than or equal to pT2, pNO) and 56% and 49% for non-organconfined, lymph node-negative tumors (n = 166; > pT2, pN0). Positive lymph nodes were found in 124 (24%) patients who had a 5-year recurrence-free (33%) or overall (26%) survival. Isolated local recurrences were observed in 3% of patients with organ-confined tumors (:5 pT2, pN0), 11% with non-organ-confined tumors (less than or equal to pT2, pN0), and 13% with positive lymph nodes (any pT, pN+). Distant metastases developed in 25% of patients with organ-confined tumors, 370% with non-organ-confined tumors, and 51% with positive lymph nodes.Conclusion: Despite negative preoperative staging, pelvic lymphadenectomy and cystectomy for bladder cancer reveal a high percentage of unsuspected nodal metastases (24%) that have a 25% chance for long-term survival. This procedure also ensures a low pelvic recurrence rate even in lymph node-positive patients, and patients with locally advanced cancer have a 56% probability of 5-year recurrence free survival. (C) 2003 by American Society of Clinical Oncology.