Pelvic lymphadenectomy in radical cystectomy

Objective To discuss the function of pelvic lymphadenectomy in radical cystectomy. Methods Ninety-five patients with bladder cancer (76 males and 19 females) underwent radical cys-tectomy. Clinical data were reviewed. Median age was 62 years old (25-78). Among all patients, 49 were newly diagnosed and 46 had recurrent disease. Of 95 patients, 87 were urothelial cell carcinoma, 5 were adenocarcinoma, and 3 were squamous cell carcinoma. Of 87 urothelial cell carcinoma cases, 17 were grade 1, 39 were grade 2, and 31 were grade 3. Of 95 patients, 10 were Ta-T1,54 were T2 ,26 were T3 ,and 5 were T4 according to AJCC classification. All cases accepted bilateral pelvic lymphade-nectomy according to standard protocol. Results Bilateral lymphadenectomy was taken an average time about 20 min. No important vessels and nerves injury occurred and average bleeding volume was 25 ml during procedure. A median of 10 lymph nodes were removed (range, 1-20). The nodal posi-tive rate was 17.9% (17/95) with 58.8% (10/17) bilateral lymph nodes positive. Short-term opera-tion-related complication rate was 12.6% (12/95). No operation-related death happened. Median fol-low up time was 34 months (3 to 64 months). Sixteen cases died during followup and the 3-year over-all survival rate was 84.5%. Conclusions Bilateral pelvic lymphadenectomy should be routinely per-formed during radical cystectomy. Standard lymphadenectomy could document accurately the staging and improve the overall survival in radical cystectomy without severe complications. Key words: Bladder neoplasms;  Lymphnode dissection