Distribution of positive lymph nodes of muscle invasive bladder cancer: analysis the pathological data from 208 consecutive cases of radical cystectomy

Abstract

Objective To describe the distribution of positive lymph nodes of muscle invasive bladder cancer, and explore the relationship between positive nodes and pathological characters. Methods Pathological data from 208 consecutive cases of muscle invasive bladder cancer were collect-ed and reviewed. The correlation of tumor grade, tumor stage and lymph nodes status was analyzed. The locations and numbers of positive nodes were recorded and compared according to the specific grade or stage. Results There were 153 cases (73.6%)of G_3 tumor and 55 cases(26.4%) of G_2 tumor and none G_1 (0%)in this cohort. The case number from pT1 to pT4 was 59(28. 4%)、58 (27.8%)、48(23.0%)and 43(20.6%), respectively. The tumor grade was positively correlated with tumor stage in this cohort (r=0. 392, P=0. 000). 153 cases had been taken lymph node dissection. There was more node positive cases in pT_3 and pT_4 than that in T_1 (P=0. 001 ,P=0. 000), as well as pT_4 compared with pT_2 (P= 0. 012). The data showed that most of the positive nodes were located within the pelvic region. There was only 1 case and 1 node positive for G_1/G_2 tumor with 24.84% of node positive cases for G_3. The positive nodes involved from pelvic to proximal artery while the stage increased. Conclusions There is less chance for low grade (G_1/G_2) bladder cancer to be node posi-tive compared with G_3 ones. It is necessary to take a extensive lymphadenectomy for the patients with stage more than T_2. Key words: Bladder neoplasms; Carcinoma; Lymph node dissection; Grade; Stage