Medizinische Universität Graz - Research portal
Selected Publication:
SHR Neuro Cancer Cardio Lipid Metab Microb
Shariat, SF; Ehdaie, B; Rink, M; Cha, EK; Svatek, RS; Chromecki, TF; Fajkovic, H; Novara, G; David, SG; Daneshmand, S; Fradet, Y; Lotan, Y; Sagalowsky, AI; Clozel, T; Bastian, PJ; Kassouf, W; Fritsche, HM; Burger, M; Izawa, JI; Tilki, D; Abdollah, F; Chun, FK; Sonpavde, G; Karakiewicz, PI; Scherr, DS; Gonen, M.
Clinical nodal staging scores for bladder cancer: a proposal for preoperative risk assessment.
Eur Urol. 2012; 61(2): 237-242.
Doi: 10.1016/j.eururo.2011.10.011
[OPEN ACCESS]
Web of Science
PubMed
FullText
FullText_MUG
- Co-authors Med Uni Graz
- Chromecki Thomas
- Altmetrics:
- Dimensions Citations:
- Plum Analytics:
- Scite (citation analytics):
- Abstract:
- BACKGROUND: Radical cystectomy (RC) with pelvic lymph node dissection (LND) is the standard of care for refractory non-muscle-invasive and muscle-invasive bladder cancer. Although consensus exists on the need for LND, its extent is still debated. OBJECTIVE: To develop a model that allows preoperative determination of the minimum number of lymph nodes (LNs) needed to be removed at RC to ensure true nodal status. DESIGN, SETTING, AND PARTICIPANTS: We analyzed data from 4335 patients treated with RC and pelvic LND without neoadjuvant chemotherapy at 12 academic centers located in the United States, Canada, and Europe. MEASUREMENTS: We estimated the sensitivity of pathologic nodal staging using a beta-binomial model and developed clinical (preoperative) nodal staging scores (cNSS), which represent the probability that a patient has LN metastasis as a function of the number of examined nodes. RESULTS AND LIMITATIONS: The probability of missing a positive LN decreased with an increasing number of nodes examined (52% if 3 nodes were examined, 40% if 5 were examined, and 26% if 10 were examined). A cNSS of 90% was achieved by examining 6 nodes for clinical Ta-Tis tumors, 9 nodes for cT1 tumors, and 25 nodes for cT2 tumors. In contrast, examination of 25 nodes provided only 77% cNSS for cT3-T4 tumors. The study is limited due to its retrospective design, its multicenter nature, and a lack of preoperative staging parameters. CONCLUSIONS: Every patient treated with RC for bladder cancer needs an LND to ensure accurate nodal staging. The minimum number of examined LNs for adequate staging depends preoperatively on the clinical T stage. Predictive tools can give a preoperative estimation of the likelihood of nodal metastasis and thereby allow tailored decision-making regarding the extent of LND at RC.
Copyright © 2011 European Association of Urology. Published by Elsevier B.V. All rights reserved. - Find related publications in this database (using NLM MeSH Indexing)
- Adult -
- Aged -
- Aged, 80 and over -
- Carcinoma - pathology
- Cystectomy - methods
- Female -
- Humans -
- Lymph Node Excision -
- Lymph Nodes - pathology
- Lymphatic Metastasis -
- Male -
- Middle Aged -
- Neoplasm Staging -
- Preoperative Period -
- Retrospective Studies -
- Risk Assessment -
- Urinary Bladder Neoplasms - pathology
- Young Adult -
- Find related publications in this database (Keywords)
- Lymph node
- Radical cystectomy
- Prognosis
- Bladder cancer
- Urothelial carcinoma
- Survival