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Prognostic impact of lymph node invasion levels in patients with bladder cancer undergoing radical cystectomy and pelvic lymphadenectomy.

作者信息

Ikeda Junichi, Ohe Chisato, Yoshida Takashi, Nakamoto Takahiro, Saito Ryoichi, Tsuta Koji, Kinoshita Hidefumi

机构信息

Department of Urology and Andrology, Kansai Medical University, Hirakata, Osaka 573-1010, Japan.

Department of Pathology, Graduate School of Medicine, Osaka Metropolitan University, Osaka 545-8585, Japan.

出版信息

Oncol Lett. 2024 Aug 29;28(5):517. doi: 10.3892/ol.2024.14650. eCollection 2024 Nov.


DOI:10.3892/ol.2024.14650
PMID:39268166
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11391254/
Abstract

Extranodal extension in metastatic lymph nodes (LNs) is a poor prognostic factor in bladder cancer (BC). Furthermore, cancer invasion levels in sentinel LNs are associated with prognosis in melanoma. The present study aimed to evaluate the LN invasion level, defined as the extent of cancer invasion in anatomical and immunological LN substructures, and compare it with the pathological node (pN) stage of the tumor-node-metastasis staging system in BC. A total of 98 patients with BC who underwent radical cystectomy and pelvic lymphadenectomy were retrospectively assessed. The LN invasion level was classified as follows: Level 0, no cancer cell within the resected LNs; Level 1, cancer cells confined to intracapsular lymph vessels and subcapsular or transverse sinuses; Level 2, cancer cells infiltrating the cortex, paracortex or medulla; and Level 3, cancer cells infiltrating or beyond the LN capsule. The proportion of patients with Levels 0, 1, 2 and 3 was 70.4% (69/98), 8.2% (8/98), 14.3% (14/98) and 7.1% (7/98), respectively. Kaplan-Meier survival curves of recurrence-free survival (RFS), cancer-specific survival (CSS) and overall survival (OS) with LN invasion levels better stratified outcome patient when using Levels 1-3 compared with pN1-3. In addition, LN invasion levels better predicted RFS, CSS and OS, in comparison with the pN stage (c-index of 0.672 vs. 0.646, 0.688 vs. 0.665, and 0.702 vs. 0.661, respectively). Finally, multivariate analysis revealed that the predictive accuracy of the model integrating pathological tumor (pT) stage and LN invasion levels in RFS, CSS and OS was greater than that of the conventional model that included pT and pN stage (c-index of 0.723 vs. 0.703, 0.710 vs. 0.694, and 0.725 vs. 0.692, respectively). In conclusion, the model with LN invasion levels accurately predicted the prognosis of patients with BC after radical cystectomy and pelvic lymphadenectomy.

摘要

相似文献

[1]
Prognostic impact of lymph node invasion levels in patients with bladder cancer undergoing radical cystectomy and pelvic lymphadenectomy.

Oncol Lett. 2024-8-29

[2]
Lymph node density vs. the American Joint Committee on Cancer TNM nodal staging system in node-positive bladder cancer in patients undergoing extended or super-extended pelvic lymphadenectomy.

Urol Oncol. 2017-4

[3]
Extranodal extension is a powerful prognostic factor in bladder cancer patients with lymph node metastasis.

Eur Urol. 2012-7-20

[4]
Prognostic value of perinodal lymphovascular invasion following radical cystectomy for lymph node-positive urothelial carcinoma.

Eur Urol. 2012-9-28

[5]
Association between the number of dissected lymph nodes during pelvic lymphadenectomy and cancer-specific survival in patients with lymph node-negative urothelial carcinoma of the bladder undergoing radical cystectomy.

Ann Surg Oncol. 2011-1-19

[6]
Molecular lymph node staging for bladder cancer patients undergoing radical cystectomy with pelvic lymph node dissection.

Urol Oncol. 2020-7

[7]
Impact of lymph node dissection in radical cystectomy for bladder cancer: How many vs how far?

Surg Oncol. 2019-6-28

[8]
Risk factors for patients with pelvic lymph node metastases following radical cystectomy with en bloc pelvic lymphadenectomy: concept of lymph node density.

J Urol. 2003-7

[9]
Cancer-specific survival after radical cystectomy and standardized extended lymphadenectomy for node-positive bladder cancer: prediction by lymph node positivity and density.

BJU Int. 2009-8

[10]
Does the greater number of lymph nodes removed during standard lymph node dissection predict better patient survival following radical cystectomy?

World J Urol. 2011-1-15

本文引用的文献

[1]
Indocyanine green fluorescence applied to gynecologic oncology: beyond sentinel lymph node.

Int J Surg. 2024-6-1

[2]
Comparison of PIV and Other Immune Inflammation Markers of Oncological and Survival Outcomes in Patients Undergoing Radical Cystectomy.

Cancers (Basel). 2024-2-3

[3]
Laparoscopic and Robotic-Assisted Extended Pelvic Lymph Node Dissection for Invasive Bladder Cancer: A Review.

Bladder (San Franc). 2023-5-31

[4]
Extranodal Extension Predicts Poor Survival Outcomes among Patients with Bladder Cancer.

Cancers (Basel). 2021-8-15

[5]
The sentinel node invasion level (SNIL) as a prognostic parameter in melanoma.

Mod Pathol. 2021-10

[6]
Comprehensive pathological assessment of histological subtypes, molecular subtypes based on immunohistochemistry, and tumor-associated immune cell status in muscle-invasive bladder cancer.

Pathol Int. 2021-3

[7]
Dataset for the reporting of carcinoma of the bladder-cystectomy, cystoprostatectomy and diverticulectomy specimens: recommendations from the International Collaboration on Cancer Reporting (ICCR).

Virchows Arch. 2020-1-8

[8]
Neoadjuvant vs. Adjuvant Chemotherapy in Muscle Invasive Bladder Cancer (MIBC): Analysis From the RISC Database.

Front Oncol. 2018-11-19

[9]
The 2016 WHO Classification of Tumours of the Urinary System and Male Genital Organs-Part A: Renal, Penile, and Testicular Tumours.

Eur Urol. 2016-2-28

[10]
Prospective mapping of lymph node metastasis in Japanese patients undergoing radical cystectomy for bladder cancer: characteristics of micrometastasis.

Jpn J Clin Oncol. 2015-9

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