Wishnow K I, Johnson D E, Ro J Y, Swanson D A, Babaian R J, von Eschenbach A C
J Urol. 1987 Mar;137(3):408-10. doi: 10.1016/s0022-5347(17)44050-x.
Between March 1, 1983 and December 31, 1985, 18 of 130 patients (14 per cent) undergoing radical cystectomy had unsuspected metastasis. In 17 patients (94 per cent) only 1 or 2 nodes were involved. The mean size of the involved nodes was 0.81 cm. and the mean size of metastasis was 0.39 cm. In patients with 1 or 2 positive nodes metastasis was not observed above the bifurcation of the common iliac arteries or lateral to the external iliac arteries. In patients in whom the primary bladder tumor was localized clearly to 1 side of the bladder unsuspected metastasis was observed only in ipsilateral lymph nodes. In accordance with these findings, we advocate a restricted pelvic lymphadenectomy in patients in whom gross examination reveals no evidence of nodal metastasis at radical cystectomy.
1983年3月1日至1985年12月31日期间，130例行根治性膀胱切除术的患者中有18例（14%）存在未被怀疑的转移。17例患者（94%）仅1个或2个淋巴结受累。受累淋巴结的平均大小为0.81厘米，转移灶的平均大小为0.39厘米。在有1个或2个阳性淋巴结的患者中，未在髂总动脉分叉上方或髂外动脉外侧观察到转移。在原发性膀胱肿瘤明确局限于膀胱一侧的患者中，仅在同侧淋巴结中观察到未被怀疑的转移。根据这些发现，我们主张对在根治性膀胱切除术中大体检查未发现淋巴结转移证据的患者行限制性盆腔淋巴结清扫术。
