1591 PROGNOSTIC ROLE OF LYMPH NODE DENSITY IN PN+ PATIENTS AT RADICAL CYSTECTOMY: A MULTICENTRE STUDY

Abstract

You have accessJournal of UrologyBladder Cancer: Invasive1 Apr 20111591 PROGNOSTIC ROLE OF LYMPH NODE DENSITY IN PN+ PATIENTS AT RADICAL CYSTECTOMY: A MULTICENTRE STUDY Giuseppe Simone, Rocco Papalia, Salvatore Guaglianone, Mariaconsiglia Ferriero, Emanuela Altobelli, Maurizio Buscarini, Angelo Naselli, Devis Collura, Carlo Introini, Paolo Puppo, Giovanni Muto, and Michele Gallucci Giuseppe SimoneGiuseppe Simone Rome, Italy More articles by this author , Rocco PapaliaRocco Papalia Rome, Italy More articles by this author , Salvatore GuaglianoneSalvatore Guaglianone Rome, Italy More articles by this author , Mariaconsiglia FerrieroMariaconsiglia Ferriero Rome, Italy More articles by this author , Emanuela AltobelliEmanuela Altobelli Rome, Italy More articles by this author , Maurizio BuscariniMaurizio Buscarini Rome, Italy More articles by this author , Angelo NaselliAngelo Naselli Genoa, Italy More articles by this author , Devis ColluraDevis Collura Turin, Italy More articles by this author , Carlo IntroiniCarlo Introini Genoa, Italy More articles by this author , Paolo PuppoPaolo Puppo Genoa, Italy More articles by this author , Giovanni MutoGiovanni Muto Turin, Italy More articles by this author , and Michele GallucciMichele Gallucci Rome, Italy More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2011.02.1641AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Lymph-node density (LN-d) in radical cystectomy (RC) proved to be a strong prognostic factor but few reports are available in literature and it remains underutilized into daily clinical practice. We analyzed the prognostic role of LN-d in a single series of patients undergone RC and we validated findings on an external series. METHODS Between May 2001 and September 2009 data of 750 RCs performed at our Institute were collected in a prospectively-maintained database. Out of 201 pN+ patients, 154 with non-metastatic urothelial carcinoma not undergone neoadjuvant treatments were selected. Out of 750 RCs performed at two different centres in the same period 133 consecutive pN+ patients were selected as external validation series. Template of LND (Lymph-node dissection) was defined as standard when all lymphatic tissue was removed from the obturator fossa up to the aortic bifurcation, limited when common nodes were not removed and aborted when LND was abandoned due to positive intraoperative frozen section. Once LN-d and lymph-node count (LN-c) cut-off values were identified by ROC analyses, the prognostic role of pT, pN, LN-d, LN-c, template and adjuvant treatments on cancer-specific survival (CSS) was assessed with univariate and multivariate Cox regression analyses. RESULTS Significant thresholds were 11% and 30% for LN-d and 9 and 30 for LN-c. Statistically significant variables at univariate analysis were pT (p<0.001), pN (p=0.015), LN-d (p<0.001), LN-c (p=0.014) and template (p<0.001). At stepwise Cox regression analysis only pT (p=0.008), LN-d (p=0.017) and Template (p=0.023) proved to have independent role on CSS. Independent prognostic factors at stepwise Cox-regression analysis were LN-d (p<0.001) and pT(p=0.039) on the external series and pT (p=0.005), LN-d (p=0.022) and template (p=0.002) on the whole cohort. CONCLUSIONS In 288 pN+ patients at RC, LN-d cut-off values of 11% and 30%, pT stage, and template of LND were the strongest prognostic factors with independent role on CSS. © 2011 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 185Issue 4SApril 2011Page: e638-e639 Advertisement Copyright & Permissions© 2011 by American Urological Association Education and Research, Inc.MetricsAuthor Information Giuseppe Simone Rome, Italy More articles by this author Rocco Papalia Rome, Italy More articles by this author Salvatore Guaglianone Rome, Italy More articles by this author Mariaconsiglia Ferriero Rome, Italy More articles by this author Emanuela Altobelli Rome, Italy More articles by this author Maurizio Buscarini Rome, Italy More articles by this author Angelo Naselli Genoa, Italy More articles by this author Devis Collura Turin, Italy More articles by this author Carlo Introini Genoa, Italy More articles by this author Paolo Puppo Genoa, Italy More articles by this author Giovanni Muto Turin, Italy More articles by this author Michele Gallucci Rome, Italy More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...