Young age increases the risk of lymph-node metastasis in patients with muscle-invasive bladder urothelial carcinoma

Zijian Tian,Tongxiang Diao,Jianye Wang,Xin Wang,Lingfeng Meng,Maolin Hu,Ming Liu,Miao Wang

doi:10.1186/s12885-020-07354-7

Abstract

BackgroundThe risk of positive lymph nodes in patients with muscle-invasive bladder urothelial carcinoma (MIBC) can be used to guide treatment recommendations. However, little is known about the effect of age on lymph node positivity (LN+). This study aimed to evaluate the effect of age on LN+ in MIBC.MethodsWe analyzed patients with stage T2–T4 bladder urothelial carcinoma who had not received preoperative radiotherapy, had at least one lymph node examined, and underwent cystectomy between 1998 and 2015. The Cochran–Armitage trend test and logistic univariate and multivariate analyses were used to evaluate the effect of age on LN+ in all T stages.ResultsIn total, 15,624 patients with MIBC were identified, including 747 patients aged ≤50 years (4.78%), 2614 patients aged 50–59 years (16.73%), 4914 patients aged 60–69 years (31.45%), 5225 patients aged 70–79 years old (33.44%), and 2124 patients aged > 80 years (13.59%). In T2–T4 staging, LN+ was negatively correlated with age. After adjustment for several covariates, multivariate logistic regression analysis revealed that age was an independent risk factor for LN+.ConclusionsIn this large SEER analysis, Young patients with MIBC have a higher risk of lymph node metastasis. This finding is worthy of further study and may eventually affect the treatment decisions of young patients.

Highlights

The risk of positive lymph nodes in patients with muscle-invasive bladder urothelial carcinoma (MIBC) can be used to guide treatment recommendations
Urothelial carcinoma accounts for approximately 90% of bladder cancers, 25% of which can develop into muscle-invasive bladder cancer
The exclusion criteria were as follows: 1. MIBC patients aged < 18 years; 2. patients with distant metastasis; 3. patients who received radiotherapy and neoadjuvant chemotherapy and chemotherapy; 4. patients who underwent local resection or local destruction surgery

Summary

Introduction

The risk of positive lymph nodes in patients with muscle-invasive bladder urothelial carcinoma (MIBC) can be used to guide treatment recommendations. Little is known about the effect of age on lymph node positivity (LN+). This study aimed to evaluate the effect of age on LN+ in MIBC. It is estimated that there will be approximately 81,400 new bladder cancer patients and 17,980 deaths due to this disease in the USA in 2020 [1]. Lymph node positivity (LN+) has been shown to be an independent predictor of disease recurrence and cancer-specific death in urothelial carcinoma of the bladder [6]. In patients with muscle-invasive bladder urothelial carcinoma (MIBC), the evaluation of LN+ is very important for staging and decisions on treatment.

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