1769 INTRAVESICAL LOCATION OF THE TUMOR: HOW DOES IT AFFECT THE PATTERN OF LYMPH NODE METASTASIS AND ONCOLOGICAL OUTCOME IN UROTHELIAL CANCER OF BLADDER?

Abstract

You have accessJournal of UrologyBladder Cancer: Invasive (III)1 Apr 20131769 INTRAVESICAL LOCATION OF THE TUMOR: HOW DOES IT AFFECT THE PATTERN OF LYMPH NODE METASTASIS AND ONCOLOGICAL OUTCOME IN UROTHELIAL CANCER OF BLADDER? Hamed Ahmadi, Gus Miranda, Jie Cai, and Siamak Daneshmand Hamed AhmadiHamed Ahmadi Los Angeles, CA More articles by this author , Gus MirandaGus Miranda Los Angeles, CA More articles by this author , Jie CaiJie Cai Los Angeles, CA More articles by this author , and Siamak DaneshmandSiamak Daneshmand Los Angeles, CA More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2013.02.2898AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES To evaluate the effect of tumor location on the pattern of lymph node metastasis (LNM) and oncological outcome in patients with bladder cancer (BC). METHODS Based on pathology reports of radical cystectomy (RC) and extended pelvic lymph node dissection (ePLND) performed at USC Institute of Urology between 1971 and 2008, five discrete anatomical locations were defined as anterior wall, posterior wall, lateral wall, dome, and trigone (including uretrovesical junction and bladder neck). Single-site tumor was considered when tumor was located exclusively in one anatomical location and tumors that involved more than one anatomical location were defined as multiple-site tumor. Pattern of LNM, overall survival (OS), and recurrence free survival (RFS) was compared among five locations and between single-site and multiple-site tumors. RESULTS Out of 1964 patients, we identified 1777 patients (1400 males) with the mean age of 67 yrs (range, 23 - 93) who had complete information on tumor location. Median follow-up was 12.9 yrs (range, 0 - 36.6). 408/1777 (22.9%) patients had single-site tumor. There was no significant difference either among five locations or between single- and multiple-site tumors with regards to percentage of LN positive disease (P=0.4), number of positive LNs (P=0.3), and LN density (P=0.3). Regarding the level of LNM one PLND template, trigone tumors were less likely to involve LNs above aortic bifurcation (LN-AAB) when compared to other locations (2/13 (15%) vs. 10/24 (41.6%); P=0.02) but there was no difference between single-site and multiple-site tumors (12/47 (34%) vs. 15/83 (38%); P=0.5).Posterior wall tumors had worse OS compared to other locations (HR=1.7; P=0.03) but there was no difference in OS between single- and multiple-site tumors (P=0.9). There was no difference in RFS either among five locations (P=0.1) or between single- and multiple-site tumors (P=0.2). (Figure 1). CONCLUSIONS There does not appear to be much difference in rate of LNM and RFS among different tumor locations. However, LNM in trigone tumors tend to be confined to area below aortic bifurcation and posterior wall tumors have worse OS. © 2013 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 189Issue 4SApril 2013Page: e727 Advertisement Copyright & Permissions© 2013 by American Urological Association Education and Research, Inc.MetricsAuthor Information Hamed Ahmadi Los Angeles, CA More articles by this author Gus Miranda Los Angeles, CA More articles by this author Jie Cai Los Angeles, CA More articles by this author Siamak Daneshmand Los Angeles, CA More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...