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dc.contributor.authorCrozier, J
dc.contributor.authorPapa, N
dc.contributor.authorPerera, M
dc.contributor.authorStewart, M
dc.contributor.authorGoad, J
dc.contributor.authorSengupta, S
dc.contributor.authorBolton, D
dc.contributor.authorLawrentschuk, N
dc.date.accessioned2020-12-21T04:10:46Z
dc.date.available2020-12-21T04:10:46Z
dc.date.issued2017-11-01
dc.identifier.citationCrozier, 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.
dc.identifier.issn2466-0493
dc.identifier.urihttp://hdl.handle.net/11343/257515
dc.description.abstractPurpose: 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.
dc.languageEnglish
dc.publisherKOREAN UROLOGICAL ASSOC
dc.titleLymph node yield in node-negative patients predicts cancer specific survival following radical cystectomy for transitional cell carcinoma
dc.typeJournal Article
dc.identifier.doi10.4111/icu.2017.58.6.416
melbourne.affiliation.departmentMedical Education
melbourne.affiliation.departmentSurgery (Austin & Northern Health)
melbourne.affiliation.departmentPhysiotherapy
melbourne.affiliation.department
melbourne.source.titleInvestigative and Clinical Urology
melbourne.source.volume58
melbourne.source.issue6
melbourne.source.pages416-422
dc.rights.licenseCC BY-NC
melbourne.elementsid1272986
melbourne.contributor.authorPerera, Marlon Lakmal
melbourne.contributor.authorGoad, Jeremy
melbourne.contributor.authorBolton, Damien
melbourne.contributor.authorLawrentschuk, Nathan
melbourne.contributor.authorSengupta, Shomik
dc.identifier.eissn2466-054X
melbourne.accessrightsOpen Access


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