The outcome of post-chemotherapy retroperitoneal lymph node dissection in patients with metastatic bladder cancer in the retroperitoneum Journal Article


Authors: Liu, N. W.; Murray, K. S.; Donat, S. M.; Herr, H. W.; Bochner, B. H.; Dalbagni, G.
Article Title: The outcome of post-chemotherapy retroperitoneal lymph node dissection in patients with metastatic bladder cancer in the retroperitoneum
Abstract: Purpose: While a definitive cure can be achieved by radical cystectomy and pelvic lymph node dissection in select patients with regional lymphadenopathy, the benefit remains uncertain in patients who present with non-regional metastases. We analyzed the survival outcomes of post-chemotherapy retroperitoneal lymph node dissection. Materials and Methods: We reviewed our institutional database and identified 13 patients with radiographically evident or biopsy proven retroperitoneal nodal metastases with a significant response to chemotherapy. These patients underwent consolidative surgery with concomitant or delayed retroperitoneal lymph node dissection. The primary endpoints were progression-free survival and disease-specific survival from the time of retroperitoneal lymph node dissection. Results: All patients had primary urothelial cell carcinoma. Twelve patients underwent concomitant radical cystectomy, pelvic and retroperitoneal lymph node dissection. Seven patients (54%) had residual disease in the retroperitoneum and the median number of retroperitoneal nodes containing metastases was 4 (IQR 2-6). Six (86%) developed disease recurrences within 2 years of surgery and 5 (71%) died of cancer. Of the 6 patients without residual disease in the retroperitoneum, 2 (33%) developed recurrences and died of disease progression. The 2-year disease-specific survival was worse for patients with residual disease in the retroperitoneum than those without residual retroperitoneal disease (34%, 95% CI 5-68 vs 50%, 95% CI 6-85). Conclusions: The presence of retroperitoneal nodal metastases at post-chemotherapy retroperitoneal lymph node dissection is a poor prognosticator. Consolidative surgery with retroperitoneal lymph node dissection provides important prognostic information and may be therapeutic in a very small subset of these patients. © 2019-IOS Press and the authors.
Keywords: surgery
Journal Title: Bladder Cancer
Volume: 5
Issue: 1
ISSN: 2352-3727
Publisher: IOS Press  
Date Published: 2019-01-01
Start Page: 13
End Page: 19
Language: English
DOI: 10.3233/blc-180186
PROVIDER: scopus
PMCID: PMC6401561
PUBMED: 30854412
DOI/URL:
Notes: Article -- Export Date: 1 March 2019 -- Source: Scopus
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MSK Authors
  1. Guido Dalbagni
    325 Dalbagni
  2. Sherri M Donat
    174 Donat
  3. Bernard Bochner
    468 Bochner
  4. Harry W Herr
    594 Herr