University Library
  • Login
A gateway to Melbourne's research publications
Minerva Access is the University's Institutional Repository. It aims to collect, preserve, and showcase the intellectual output of staff and students of the University of Melbourne for a global audience.
View Item 
  • Minerva Access
  • Medicine, Dentistry & Health Sciences
  • Melbourne Medical School
  • Medical Education
  • Medical Education - Research Publications
  • View Item
  • Minerva Access
  • Medicine, Dentistry & Health Sciences
  • Melbourne Medical School
  • Medical Education
  • Medical Education - Research Publications
  • View Item
JavaScript is disabled for your browser. Some features of this site may not work without it.

    Lymph node yield in node-negative patients predicts cancer specific survival following radical cystectomy for transitional cell carcinoma

    Thumbnail
    Download
    published version (3.361Mb)

    Citations
    Scopus
    Web of Science
    Altmetric
    5
    4
    Author
    Crozier, J; Papa, N; Perera, M; Stewart, M; Goad, J; Sengupta, S; Bolton, D; Lawrentschuk, N
    Date
    2017-11-01
    Source Title
    Investigative and Clinical Urology
    Publisher
    KOREAN UROLOGICAL ASSOC
    University of Melbourne Author/s
    Perera, Marlon Lakmal; Goad, Jeremy; Bolton, Damien; Lawrentschuk, Nathan; Sengupta, Shomik
    Affiliation
    Medical Education
    Surgery (Austin & Northern Health)
    Physiotherapy
    Metadata
    Show full item record
    Document Type
    Journal Article
    Citations
    Crozier, J., Papa, N., Perera, M., Stewart, M., Goad, J., Sengupta, S., Bolton, D. & Lawrentschuk, N. (2017). Lymph node yield in node-negative patients predicts cancer specific survival following radical cystectomy for transitional cell carcinoma. INVESTIGATIVE AND CLINICAL UROLOGY, 58 (6), pp.416-422. https://doi.org/10.4111/icu.2017.58.6.416.
    Access Status
    Open Access
    URI
    http://hdl.handle.net/11343/257515
    DOI
    10.4111/icu.2017.58.6.416
    Abstract
    Purpose: To determine the oncological implications of increased nodal dissection in node-negative bladder cancer during radical cystectomy in a contemporary Australian series. Materials and Methods: We performed a multicenter retrospective study, including more than 40 surgeons across 5 sites over a 10-year period. We identified 353 patients with primary bladder cancer undergoing radical cystectomy. Extent of lymphadenectomy was defined as follows; limited pelvic lymph node dissection (PLND) (perivesical, pelvic, and obturator), standard PLND (internal and external iliac) and extended PLND (common iliac). Multivariable cox proportional hazards and logistic regression models were used to determine LNY effect on cancer-specific survival. Results: Over the study period, the extent of dissection and lymph node yield increased considerably. In node-negative patients, lymph node yield (LNY) conferred a significantly improved cancer-specific survival. Compared to cases where LNY of 1 to 5 nodes were taken, the hazard ratio (HR) for 6 to 15 nodes harvested was 0.78 (95% confidence interval [CI], 0.43-1.39) and for greater than 15 nodes the HR was 0.31 (95% CI, 0.17-0.57), adjusted for age, sex, T stage, margin status, and year of surgery. The predicted probability of cancer-specific death within 2 years of cystectomy was 16% (95% CI, 13%-19%) with 10 nodes harvested, falling to 5.5% (95% CI, 0%-12%) with 30 nodes taken. Increasing harvest in all PLND templates conferred a survival benefit. Conclusions: The findings of the current study highlight the improved oncological outcomes with increased LNY, irrespective of the dissection template. Further prospective research is needed to aid LND data interpretation.

    Export Reference in RIS Format     

    Endnote

    • Click on "Export Reference in RIS Format" and choose "open with... Endnote".

    Refworks

    • Click on "Export Reference in RIS Format". Login to Refworks, go to References => Import References


    Collections
    • Minerva Elements Records [45689]
    • Physiotherapy - Research Publications [391]
    • Surgery (Austin & Northern Health) - Research Publications [277]
    • Medical Education - Research Publications [497]
    Minerva AccessDepositing Your Work (for University of Melbourne Staff and Students)NewsFAQs

    BrowseCommunities & CollectionsBy Issue DateAuthorsTitlesSubjectsThis CollectionBy Issue DateAuthorsTitlesSubjects
    My AccountLoginRegister
    StatisticsMost Popular ItemsStatistics by CountryMost Popular Authors