Current controversies on the role of lymphadenectomy for bladder cancer

Urol Oncol. 2019 Mar;37(3):193-200. doi: 10.1016/j.urolonc.2018.05.005. Epub 2018 Jun 15.

Abstract

Significant evidence exists regarding the diagnostic and therapeutic roles of pelvic lymph node dissection at the time of radical cystectomy for patients with bladder cancer. Despite this, lymphadenectomy for bladder cancer is still underutilized and even where performed, controversies exist in regard to what defines an adequate dissection and whether or not the indications for lymphadenectomy have changed now that we are firmly entrenched in the neoadjuvant chemotherapy era. A comprehensive literature review was performed to touch on these important issues and highlight future directions and current trials that will soon provide more clarity for surgeons and patients dealing with bladder cancer.

Keywords: Bladder cancer; Cystectomy; Lymphadenectomy; Urothelial carcinoma.

Publication types

  • Review

MeSH terms

  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use*
  • Cisplatin / therapeutic use
  • Cystectomy / adverse effects
  • Cystectomy / methods*
  • Cystectomy / trends
  • Disease-Free Survival
  • Humans
  • Lymph Node Excision / adverse effects
  • Lymph Node Excision / methods*
  • Lymph Node Excision / trends
  • Lymph Nodes / pathology
  • Lymph Nodes / surgery
  • Lymphatic Metastasis / pathology
  • Neoadjuvant Therapy / methods
  • Neoplasm Recurrence, Local / epidemiology
  • Neoplasm Recurrence, Local / prevention & control*
  • Randomized Controlled Trials as Topic
  • Survival Analysis
  • Urinary Bladder / pathology
  • Urinary Bladder / surgery
  • Urinary Bladder Neoplasms / mortality
  • Urinary Bladder Neoplasms / pathology
  • Urinary Bladder Neoplasms / therapy*

Substances

  • Cisplatin