廣泛性淋巴廓清術改善肌肉侵入性膀胱癌患者的預後-全國癌登資料分析
楊登凱1、陳忠信2、吳文正3
1永和耕莘醫院外科部2國立台灣大學附設醫院泌尿部 3高雄市立大同醫院
Extended lymphadenectomy improves the prognosis of the patients with muscle invasive bladder cancer: analysis from the nationwide cancer registry database
Teng-Kai Yang 1, Chung-Hsin Chen 2, Wen-Jeng Wu3
1Surgery department, Yonghe Cardinal Hospital, New Taipei city, Taiwan;
2Department of Urology, National Taiwan University Hospital, Taipei, Taiwan;
3 Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung, Taiwan;
Purpose: This study was designed to assess the impact of the number of dissected lymph nodes (LNs) on overall survival (OS) and cancer specific survival (CSS) in patients undergoing radical cystectomy (RC) for bladder cancer.
Materials and Methods: From 2008 to 2013, 289 patients undergoing RC for treating muscle invasive bladder urothelial carcinoma staging T2-4N0 were selected from Taiwan cancer registry database. The number of removed LNs, age, gender, pathological grade and stage, and pre-operative image findings were assessed. The Cox proportional hazard model was used to evaluate the impact of the number of removed LNs on overall survival (OS) and cancer specific survival (CSS).
Results: After stratifying patients by the number of removed LNs, we discovered there were no significant differences of tumor stages, grade, age, and gender. In multivariate regression models, after the adjustment of age, gender, pathological grade and pathological stage, there was a statistically significant improvement OS (HR: 0.40; 95% CI: 0.20-0.82) and CSS (HR: 0.58; 95% CI: 0.36-0.92) in the patients who had dissected LNs of more than 10 compared to those with fewer dissected LNs
Conclusions: In patients undergoing RC, dissected LNs of more than 10 was associated with a significantly better OS and CSS. That indicated an extended lymphadenectomy would be helpful for improving patients’ prognosis.