Stanford Urology Chair Co-Authors New Study on Lymphadenectomy for Bladder Cancer Published by NEJM

The New England Journal of Medicine has published a new study, 'Standard or Extended Lymphadenectomy for Bladder Cancer,' co-authored by Stanford Urology Chair, Eila Skinner, MD.

In this study, researchers assessed whether patients undergoing radical cystectomy for localized mus-cle-invasive bladder cancer would have a lower risk of recurrence or death with extended lymphadenectomy than with standard lymphadenectomy.

Why was the trial done?

In radical cystectomy procedures, the anatomical extent and number of pelvic lymph nodes removed varies because of a lack of data from clinical trials. Some observational studies have suggested that extended lymph-adenectomy (which includes removal of common iliac, presciatic, and presacral nodes) may provide a greater survival benefit than standard lymphadenectomy.

How was the trial concluded?

592 patients with urothelial bladder cancer of clinical stage T2 (confined to muscle) to T4a (invading adjacent organs) and two or fewer positive lymph nodes who elected to undergo radical cystectomy with curative intent were assigned to undergo either extended or standard bilateral pelvic lymph-adenectomy. The primary outcome was disease-free survival.

Results?

Estimated 5-year disease-free survival in the extended-lymphadenectomy group was similar to that in the stan-dard-lymphadenectomy group. Overall survival, a secondary outcome, was also similar in the two groups.