Abstract：Objective:To compare the prognosis of patients with extended lymphadenectomy versus standard lymphadenectomy at laparoscopic radical cystectomy (LRC).Methods:A retrospective analysis was done of 75 cases with bladder cancer who received radical cystectomy between March 2008 and July 2012 in our hospital. The patients did not receive any neo-adjuvant or adjuvant radio-therapy of the 75 patients, 33 received extended lymphadenectomy and the other 42 underwent standard lymphadenectomy. Kaplan-Meier curve was used to compare the disease free survival of patients in two groups.To avoid the effect of learning curve, we just compared the operation technique and the incidence rate of complications between two groups which including the patients after February 2010 only.Results:Among the patients after February 2010, the average number of lymph node removed in the extended lymphadenectomy group were (20.30±6.66) compared with (13.95±6.49) in the standard lymphadenectomy (P<0.05). There's no statistical significance between two group's mean operation time and blood loss (P>0.05). In a total of 75 patients,the 6、12、18、24 months disease-free survival (DSF) in the extended lymphadenectomy group were 93%、89%、84%、77% respectively. In the standard lymphadenectomy the corresponding figures were 85%、76%、62%、59% respectively (P=0.081). When restricting the analyses to lymph node-positive patients, patients with extended lymphadenectomy had much better DSF compared with patients with standard lymphadenectomy (P=0.048).Conclusions:Extended lymphadenectomy is associated with better DFS for lymph node-positive patients who underwent LRC. It did not contribute significantly to the operative time, intraoperative bleeding and postoperative complications. The extent of lymph node resection is an important prognostic factor for bladder cancer after operation.
欧阳晨思, 傅斌, 王共先, 曹润福, 孙庭, 崔苏萍, 冯亮, 习海波, 余月, 傅龙龙, 周晓晨. 膀胱癌扩大淋巴结清扫术的意义及复发相关因素的分析[J]. 微创泌尿外科杂志, 2013, 2(2): 92-96.
Ouyang Chensi, Fu Bin, Wang Gongxian, Cao Runfu, Sun Ting, Cui Suping, Feng Liang, Xi Haibo, Yu Yue, Fu Longlong, Zhou Xiaochen. Clinical significance of radical cystectomy with extended lymphadenectomy and Influencing factors associated with recurrence of bladder cancer. JOURNAL OF MINIMALLY INVASIVE UROLOGY, 2013, 2(2): 92-96.
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