The Role of Lymph Node Dissection in the Treatment of Bladder Cancer
Lymph node dissection (LND; PLND: pelvic LND) is an essential component of radical cystectomy (RC) for bladder cancer (BC). However, the optimal anatomical extent of LND and its potential therapeutic role are still controversial: as we will explain, the extent of LND dissection is a predictor of sur...
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doaj-316636691f514cd1b52191c7f55bc6612020-11-24T23:51:18ZengFrontiers Media S.A.Frontiers in Surgery2296-875X2018-10-01510.3389/fsurg.2018.00062415215The Role of Lymph Node Dissection in the Treatment of Bladder CancerFrancesco Cattaneo0Giovanni Motterle1Filiberto Zattoni2Alessandro Morlacco3Fabrizio Dal Moro4Fabrizio Dal Moro5Clinica Urologica, Dipartimento di Scienze Chirurgiche, Oncologiche e Gastroenterologiche, Università degli Studi di Padova, Padova, ItalyClinica Urologica, Dipartimento di Scienze Chirurgiche, Oncologiche e Gastroenterologiche, Università degli Studi di Padova, Padova, ItalyClinica Urologica, Dipartimento di Scienze Chirurgiche, Oncologiche e Gastroenterologiche, Università degli Studi di Padova, Padova, ItalyClinica Urologica, Dipartimento di Scienze Chirurgiche, Oncologiche e Gastroenterologiche, Università degli Studi di Padova, Padova, ItalyClinica Urologica, Dipartimento di Scienze Chirurgiche, Oncologiche e Gastroenterologiche, Università degli Studi di Padova, Padova, ItalyClínica Urologica, Ospedale “Santa Maria della Misericordia”, Università di Udine, Udine, ItalyLymph node dissection (LND; PLND: pelvic LND) is an essential component of radical cystectomy (RC) for bladder cancer (BC). However, the optimal anatomical extent of LND and its potential therapeutic role are still controversial: as we will explain, the extent of LND dissection is a predictor of survival and local recurrence but what is an adequate extension is still unclear. Moreover, there is large uncertainty about the role of surgery in patients with clinically-positive nodes. In this review we will provide a synthesis of the available evidence on this highly debated topic. Overall, the studies presented in this work support the idea that extended lymphadenectomy could provide optimal diagnostic and possibly therapeutic results in cN- patients. In cN+ patients, post chemotherapy surgery may be considered especially in subjects who have a good response to CHT, although definitive evidence is still needed. Finally, the final results of randomized trials are eagerly awaited to draw definitive conclusions of the role of PLND in BC.https://www.frontiersin.org/article/10.3389/fsurg.2018.00062/fullbladder cancerlymph nodeslymph node dissectionradical cystectomynodal disease |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Francesco Cattaneo Giovanni Motterle Filiberto Zattoni Alessandro Morlacco Fabrizio Dal Moro Fabrizio Dal Moro |
spellingShingle |
Francesco Cattaneo Giovanni Motterle Filiberto Zattoni Alessandro Morlacco Fabrizio Dal Moro Fabrizio Dal Moro The Role of Lymph Node Dissection in the Treatment of Bladder Cancer Frontiers in Surgery bladder cancer lymph nodes lymph node dissection radical cystectomy nodal disease |
author_facet |
Francesco Cattaneo Giovanni Motterle Filiberto Zattoni Alessandro Morlacco Fabrizio Dal Moro Fabrizio Dal Moro |
author_sort |
Francesco Cattaneo |
title |
The Role of Lymph Node Dissection in the Treatment of Bladder Cancer |
title_short |
The Role of Lymph Node Dissection in the Treatment of Bladder Cancer |
title_full |
The Role of Lymph Node Dissection in the Treatment of Bladder Cancer |
title_fullStr |
The Role of Lymph Node Dissection in the Treatment of Bladder Cancer |
title_full_unstemmed |
The Role of Lymph Node Dissection in the Treatment of Bladder Cancer |
title_sort |
role of lymph node dissection in the treatment of bladder cancer |
publisher |
Frontiers Media S.A. |
series |
Frontiers in Surgery |
issn |
2296-875X |
publishDate |
2018-10-01 |
description |
Lymph node dissection (LND; PLND: pelvic LND) is an essential component of radical cystectomy (RC) for bladder cancer (BC). However, the optimal anatomical extent of LND and its potential therapeutic role are still controversial: as we will explain, the extent of LND dissection is a predictor of survival and local recurrence but what is an adequate extension is still unclear. Moreover, there is large uncertainty about the role of surgery in patients with clinically-positive nodes. In this review we will provide a synthesis of the available evidence on this highly debated topic. Overall, the studies presented in this work support the idea that extended lymphadenectomy could provide optimal diagnostic and possibly therapeutic results in cN- patients. In cN+ patients, post chemotherapy surgery may be considered especially in subjects who have a good response to CHT, although definitive evidence is still needed. Finally, the final results of randomized trials are eagerly awaited to draw definitive conclusions of the role of PLND in BC. |
topic |
bladder cancer lymph nodes lymph node dissection radical cystectomy nodal disease |
url |
https://www.frontiersin.org/article/10.3389/fsurg.2018.00062/full |
work_keys_str_mv |
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