PD60-11 PROGNOSTIC SIGNIFICANCE OF PERIVESICAL LYMPH NODE STATUS IN PATIENTS WITH MUSCLE-INVASIVE BLADDER CANCER UNDERGOING RADICAL CYSTECTOMY

Abstract

You have accessJournal of UrologyBladder Cancer: Invasive VI (PD60)1 Apr 2020PD60-11 PROGNOSTIC SIGNIFICANCE OF PERIVESICAL LYMPH NODE STATUS IN PATIENTS WITH MUSCLE-INVASIVE BLADDER CANCER UNDERGOING RADICAL CYSTECTOMY Nathan C. Wong*, Melissa Assel, Cristina Falavolti, Chun Huang, Nima Almassi, Shawn Dason, Victor A. McPherson, Lucas W. Dean, Daniel Sjoberg, Nicole Benfante, Hikmat Al-Ahmadie, Guido Dalbagni, Andrew VIckers, Eugene Cha, and Bernard H. Bochner Nathan C. Wong*Nathan C. Wong* More articles by this author , Melissa AsselMelissa Assel More articles by this author , Cristina FalavoltiCristina Falavolti More articles by this author , Chun HuangChun Huang More articles by this author , Nima AlmassiNima Almassi More articles by this author , Shawn DasonShawn Dason More articles by this author , Victor A. McPhersonVictor A. McPherson More articles by this author , Lucas W. DeanLucas W. Dean More articles by this author , Daniel SjobergDaniel Sjoberg More articles by this author , Nicole BenfanteNicole Benfante More articles by this author , Hikmat Al-AhmadieHikmat Al-Ahmadie More articles by this author , Guido DalbagniGuido Dalbagni More articles by this author , Andrew VIckersAndrew VIckers More articles by this author , Eugene ChaEugene Cha More articles by this author , and Bernard H. BochnerBernard H. Bochner More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000000977.011AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Although the prognostic significance of pelvic lymph node metastasis at radical cystectomy is well described, the implications of positive perivesical nodes are less clear. Herein, we investigated the prognostic significance of perivesical nodal metastases detected at cystectomy. METHODS: We retrospectively reviewed patients who underwent radical cystectomy and packeted pelvic lymph node dissection at our institution between 2000 and 2015, excluding patients with locally advanced disease or who received non-standard preoperative systemic therapies. Nodes identified in the en bloc cystectomy specimen following node dissection were defined as perivesical. We calculated survival outcomes by nodal status and location (perivesical vs other pelvic) and compared hazard ratios for number of positive nodes by location using Cochran’s Q. RESULTS: Of the 2,197 patients included, a median of 19 (IQR 12, 28) lymph nodes were removed, with 397 (18%) patients having nodal metastasis. The majority of node-positive patients had only positive pelvic nodes (306, 77%), while 29 (7%) had only positive perivesical nodes and 62 (16%) had both. Among node-positive patients, there was similar recurrence-free and overall survival based on location (log-rank p=0.4, and 0.8, respectively). Perivesical and other pelvic positive nodes had a similar prognostic impact with hazard ratio for recurrence (adjusted for consensus T-stage) of 1.20 vs 1.09 respectively per additional positive node (p=0.093 for heterogeneity of hazard ratios). CONCLUSIONS: Positive perivesical lymph nodes identified at time of cystectomy carry similar prognostic implications as positive pelvic nodes found during templated packeted lymphadenectomy. Although infrequently found in the absence of positive pelvic nodes, the identification and reporting of perivesical nodes improves staging and can help guide use of adjuvant therapies to improve patient outcomes. Source of Funding: This research was supported by the Sidney Kimmel Center for Prostate and Urologic Cancers and funded in part through the NIH/NCI Cancer Center Support Grant P30 CA008748. © 2020 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 203Issue Supplement 4April 2020Page: e1279-e1279 Advertisement Copyright & Permissions© 2020 by American Urological Association Education and Research, Inc.MetricsAuthor Information Nathan C. Wong* More articles by this author Melissa Assel More articles by this author Cristina Falavolti More articles by this author Chun Huang More articles by this author Nima Almassi More articles by this author Shawn Dason More articles by this author Victor A. McPherson More articles by this author Lucas W. Dean More articles by this author Daniel Sjoberg More articles by this author Nicole Benfante More articles by this author Hikmat Al-Ahmadie More articles by this author Guido Dalbagni More articles by this author Andrew VIckers More articles by this author Eugene Cha More articles by this author Bernard H. Bochner More articles by this author Expand All Advertisement PDF downloadLoading ...