Małkiewicz Bartosz, Kiełb Paweł, Gurwin Adam, Knecht Klaudia, Wilk Karol, Dobruch Jakub, Zdrojowy Romuald
Department of Urology and Oncologic Urology, Wroclaw Medical University, 50-556 Wroclaw, Poland.
First Department of Urology, Centre of Postgraduate Medical Education, 01-813 Warsaw, Poland.
Medicina (Kaunas). 2021 Apr 25;57(5):415. doi: 10.3390/medicina57050415.
The purpose of this review is to present the current status of lymph node dissection (LND) during radical cystectomy in patients with bladder cancer (BCa). Despite the growing body of evidence of LND utility at the time of radical cystectomy (RC) in high-risk nonmuscle-invasive and muscle-invasive BCa (MIBC), therapeutic and prognostic value and optimal extent of LND remain unsolved issues. Recently published results of the first prospective, a randomized trial assessing the therapeutic benefit of extended versus limited LND during RC, failed to demonstrate survival improvement with the extended template. Although LND is the most accurate staging procedure, the direct therapeutic effect is still not evident from the current literature, limiting the possibility of establishing clear recommendations. This indicates the need for robust and adequately powered clinical trials.
本综述的目的是介绍膀胱癌（BCa）患者根治性膀胱切除术中淋巴结清扫（LND）的现状。尽管越来越多的证据表明，在高危非肌层浸润性和肌层浸润性膀胱癌（MIBC）的根治性膀胱切除术（RC）时，LND具有实用价值，但LND的治疗和预后价值以及最佳范围仍是未解决的问题。最近发表的第一项前瞻性随机试验结果评估了RC期间扩大与有限LND的治疗益处，但未能证明扩大模板能改善生存率。尽管LND是最准确的分期程序，但目前的文献中仍未明确其直接治疗效果，这限制了制定明确建议的可能性。这表明需要进行有力且样本量充足的临床试验。
