Editorial Comment

Abstract

The authors have confirmed a growing body of evidence showing that positive soft-tissue surgical margins significantly reduces the recurrence-free, disease-specific, and overall survival of patients with invasive bladder cancer after radical cystectomy. A positive margin is a harbinger of local recurrence and eventual death from bladder cancer. Surprisingly, the authors also showed that even patients with positive margins and node-negative disease had better survival if >15 lymph nodes were removed. This suggests that meticulous pelvic lymph node dissection might improve surgical cure of patients with locally advanced bladder cancer. A Thorough Pelvic Lymph Node Dissection in Presence of Positive Margins Associated With Better Clinical Outcomes in Radical Cystectomy PatientsUrologyVol. 74Issue 1PreviewTo evaluate the effect of positive surgical margins in patients with muscle-invasive transitional cell carcinoma of the bladder on survival. Full-Text PDF Editorial CommentUrologyVol. 74Issue 1PreviewThis article is a retrospective survey of radical cystectomy and pelvic lymph node dissection (PLND) for urothelial cancer performed by a single surgeon, at a single institution, during an 18-year period. In the entire cohort of patients, the authors report that positive surgical margins have a decidedly adverse influence on recurrence-free survival, as well as disease-specific and overall survival (OS), an observation already cited in other cystectomy series. This is not surprising in this series, particularly because some of the procedures were performed for palliation rather than cure, ensuring that a number of patients (the authors do not report how many) had advanced disease at surgery. Full-Text PDF