PD60-08 ONCOLOGICAL OUTCOMES FOLLOWING RADICAL CYSTECTOMY FOR UROTHELIAL CARCINOMA OF THE BLADDER WITH POSITIVE LYMPH NODES

Abstract

You have accessJournal of UrologyBladder Cancer: Invasive VI (PD60)1 Apr 2020PD60-08 ONCOLOGICAL OUTCOMES FOLLOWING RADICAL CYSTECTOMY FOR UROTHELIAL CARCINOMA OF THE BLADDER WITH POSITIVE LYMPH NODES Seyedeh-Sanam Ladi Seyedian*, Zhoobin Bateni, Shane Pearce, Saum Ghodoussipour, Azadeh Nazemi, Jie Cai, Gus Miranda, Sumeet Bhanvadia, Hooman Djaladat, Anne Schuckman, and Siamak Daneshmand Seyedeh-Sanam Ladi Seyedian*Seyedeh-Sanam Ladi Seyedian* More articles by this author , Zhoobin BateniZhoobin Bateni More articles by this author , Shane PearceShane Pearce More articles by this author , Saum GhodoussipourSaum Ghodoussipour More articles by this author , Azadeh NazemiAzadeh Nazemi More articles by this author , Jie CaiJie Cai More articles by this author , Gus MirandaGus Miranda More articles by this author , Sumeet BhanvadiaSumeet Bhanvadia More articles by this author , Hooman DjaladatHooman Djaladat More articles by this author , Anne SchuckmanAnne Schuckman More articles by this author , and Siamak DaneshmandSiamak Daneshmand More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000000977.08AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: We sought to determine oncological outcomes among patients who underwent radical cystectomy (RC) for urothelial carcinoma (UC) of the bladder with positive lymph nodes (LN). METHODS: On a retrospective review of 4093 patients from our institutional IRB approved cystectomy database from Jan 1971 to Dec 2017, we identified 3284 patients who underwent RC for UC of the bladder. We included patients with positive LNs at the final pathology. The data was stratified into three groups based on number of positive LNs: 1, 2-9, and more than 10 positive LNs. Multivariable analysis was performed to identify prognostic factors for overall survival (OS) and recurrence-free survival (RFS). A subgroup analysis was performed to assess the oncological outcomes in cases that did not receive any chemotherapy (adjuvant or neoadjuvant). RESULTS: 712 patients (22%) had positive LN after RC. Median age was 68 years and 76% of patients were male. 105 (15%) patients had clinical evidence of LN involvement on pre-operative imaging. Patient characteristics are provided in Table 1. Five-year (5-y) RFS for 1, 2-9 and 10+ positive LNs was 39%, 36% and 16%, respectively (p<0.001) and 5-y OS were 45%, 33% and 14%, respectively (p<0.001). On multivariable analysis, more than 10 positive LNs, pathologic tumor stage >pT2, and neoadjuvant chemotherapy were associated with increased risk of recurrence and worse overall survival after radical cystectomy. Adjuvant chemotherapy was associated with decreased risk of recurrence and better overall survival after radical cystectomy. On subgroup analysis of patients with positive LNs without peri-operative chemotherapy, 5-y RFS for 1, 2-9 and 10+ positive LNs was 25%, 32% and 5%, respectively (p<0.001) and 5-y OS was 31%, 20% and 4%, respectively (p<0.001). CONCLUSIONS: Only 15% of patients with positive LNs have clinical evidence of LN involvement prior to cystectomy. Oncological outcomes after radical cystectomy are associated with the number of involved LNs. Surgery alone can be curative in 20-30% of patients with less than 10+ LN. Source of Funding: None © 2020 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 203Issue Supplement 4April 2020Page: e1277-e1277 Advertisement Copyright & Permissions© 2020 by American Urological Association Education and Research, Inc.MetricsAuthor Information Seyedeh-Sanam Ladi Seyedian* More articles by this author Zhoobin Bateni More articles by this author Shane Pearce More articles by this author Saum Ghodoussipour More articles by this author Azadeh Nazemi More articles by this author Jie Cai More articles by this author Gus Miranda More articles by this author Sumeet Bhanvadia More articles by this author Hooman Djaladat More articles by this author Anne Schuckman More articles by this author Siamak Daneshmand More articles by this author Expand All Advertisement PDF downloadLoading ...