Impact of lymph-node dissection during radical cystectomy for non-muscle-invasive bladder cancer: Japanese multicenter retrospective study.
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Sazuka Tomokazu, Taoka Rikiya, Miki Jun, Saito Ryoichi, Fukuokaya Wataru, Matsui Yoshiyuki, Hatakeyama Shingo, Kawahara Takashi, Matsuda Ayumu, Kawai Taketo, Kato Minoru, Sano Takeshi, Urabe Fumihiko, Kashima Soki, Naito Hirohito, Murakami Yoji, Miyake Makito, Daizumoto Kei, Matsushita Yuto, Hayashi Takuji, Inokuchi Junichi, Sugino Yusuke, Shiga Kenichiro, Yamaguchi Noriya, Yamamoto Shingo, Yasue Keiji, Abe Takashige, Nakanishi Shotaro, Hashine Katsuyoshi, Sawada Atsuro, Nishihara Kiyoaki, Matsumoto Hiroaki, Tatarano Shuichi, Wada Koichiro, Sekito Sho, Maruyama Ryo, Nishiyama Naotaka, Nishiyama Hiroyuki, Kitamura Hiroshi, Ichikawa Tomohiko, Japan Urological Oncology Group
Аннотация
METHODS: We retrospectively analyzed data for 2674 cases of bladder cancer treated with radical cystectomy between January 2013 and December 2019 from a multicenter Japanese database; 410 patients were preoperatively diagnosed with NMIBC. Patients were divided into lymph-node dissection and non-lymph-node dissection groups, and NUTRFS and overall survival were compared as endpoints. Univariate and multivariate analyses were performed to determine NUTRFS prognostic factors.
RESULTS: Lymph-node dissection was performed in 374/410 patients and not in 36/410. Compared with the lymph-node dissection group, the non-lymph-node dissection group was older, and had a lower proportion of a performance status of 0 and a higher proportion of clinical stage < T1 disease. The pathological lymph-node positivity rate in the lymph-node dissection group was 6.9%. However, lymph-node dissection did not provide a statistically significant prolonged survival. Results remained consistent after propensity score matching. Multivariate analysis revealed poor performance status and bladder neck tumors as independent risk factors for NUTRFS. Lymph-node dissection was not a significant prognostic factor in preoperatively diagnosed NMIBC.
CONCLUSIONS: Routine lymph-node dissection may be unnecessary for all NMIBC cases; however, our findings suggest that this should be considered for NMIBC involving the bladder neck.