Role of lymphadenectomy during cystectomy in advanced and metastatic bladder cancer
Summary. Introduction. Cytoreductive cystectomy is a part of complex surgery in patients with locally advanced and metastatic bladder cancer (BC). Lymphadenectomy is a part of standart cystectomy, although its impact on symptoms reduction is quite unknown. Our objective was to study the efficacy of lymphadenectomy during surgical treatment of patients with advanced and metastatic BC. Materials and methods. Prospective study of 36 patients with locally advanced and metastatic BC. Patients divided into 2 groups with regard to performance of standard pelvic lymphadenectomy during cystectomy. During analysis of 2 groups there was no statistical difference in major parameters: age, male/female ratio, ECOG status and TNM stage distribution between the groups. Results. There was no statistically significant difference between the groups in terms of postoperative hospital stay, blood transfusion rate and in perioperative complications rates, with only one significant intraoperative complication — external iliac vein trauma that needed vascular reconstruction. Late postoperative complications rate were equal with 2 (1 in each group) complications that needed reoperation within 30 days after surgery. Survival analysis showed no difference in overall survival rates at 2 and 3 years with 58% vs 59% and 49% vs 49% respectively for both groups. Conclusion. Our study revealed that in symptomatic patients with advanced and metastatic BC cystectomy may be performed without standard lymphadenectomy. Such approach may improve surgical outcomes decreasing overall operative time and intraoperative complications associated with lymphadenectomy without impact on overall survival.
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