Korean J Urol.  2012 Jan;53(1):14-17. 10.4111/kju.2012.53.1.14.

Pattern of Lymph Node Metastasis Correlates with Tumor Location in Bladder Cancer

• Park WK
• Kim YS

• KMID: 1988817
• DOI: http://doi.org/10.4111/kju.2012.53.1.14

Abstract

PURPOSE
Resection of a large number of lymph nodes (LNs) increases survival in patients with LN-positive disease; however, morbidity also increases. Here, we investigated the correlation between tumor location and LN metastasis in bladder cancer.
MATERIALS AND METHODS
Thirty-six patients with pathological N1 or higher bladder cancer, who underwent radical cystectomy with extended lymphadenectomy, were reviewed retrospectively. The tumor location was classified as right, left, front, posterior, or whole bladder. The LN metastasis pattern was classified as right, left, or bilateral. The correlation between tumor location and LN metastasis was determined by chi-square test. Survival rates were compared by Kaplan-Meier analysis.
RESULTS
The numbers of patients with a tumor on the right (group 1), left (group 2), posterior (group 3), or whole (group 4) bladder were 16 (44.4%), 16 (44.4%), 2 (5.6%), and 2 (5.6%), respectively. In group 1, 14 patients (87.5%) had right-sided ipsilateral LNs, and 2 patients (12.5%) had left-sided contralateral LNs. In group 2, 4 patients (25%) had right-sided contralateral LNs, and 12 patients (75%) had left-sided ipsilateral LNs. In group 3, both patients (100%) had right-sided posterior LNs. In group 4, both patients (100%) had positive LNs on both sides. Tumor location and LN metastasis were significantly correlated (p<0.05). Moreover, the survival rate was significantly higher in patients with no LN metastasis than in patients with ipsilateral or contralateral LN-positive bladder cancer.
CONCLUSIONS
The location of the bladder tumor and direction of metastatic spread were significantly correlated. Mandatory bilateral lymphadenectomy during radical cystectomy should be questioned.

Keyword

Lymph node excision; Neoplasm metastasis; Urinary bladder neoplasms

MeSH Terms

Cystectomy
Humans
Lymph Node Excision
Lymph Nodes
Neoplasm Metastasis
Retrospective Studies
Survival Rate
Urinary Bladder
Urinary Bladder Neoplasms

Figure

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  FIG. 1 Kaplan-Meier analysis of survival rates.

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