van Gennep, Erik J. and Claps, Francesco and Bostrom, Peter J. and Shariat, Shahrokh F. and Neuzillet, Yann and Zlotta, Alexandre R. and Trombetta, Carlo and Eckstein, Markus and Mertens, Laura S. and Bussani, Rossana and Burger, Maximilian and Boormans, Joost L. and Wullich, Bernd and Hartmann, Arndt and Mayr, Roman and Pavan, Nicola and Bartoletti, Riccardo and Mir, M. Carmen and Pouessel, Damien and van der Hoeven, John and van der Kwast, Theo H. and Allory, Yves and Zuiverloon, Tahlita C. M. and Lotan, Yair and van Rhijn, Bas W. G. (2024) Multi-Center Assessment of Lymph-Node Density and Nodal-Stage to Predict Disease-Specific Survival in Patients with Bladder Cancer Treated by Radical Cystectomy. BLADDER CANCER, 10 (2). pp. 119-132. ISSN 2352-3727, 2352-3735
Full text not available from this repository. (Request a copy)Abstract
BACKGROUND: Prognostic tools in pathological-node (pN) patients after radical cystectomy (RC) are needed. OBJECTIVE: To evaluate the prognostic impact of lymph node (LN)-density on disease-specific survival (DSS) in patients with bladder cancer (BC) undergoing RC with pelvic lymph node dissection. METHODS: We analyzed a multi-institutional cohort of 1169 patients treated with upfront RC for cT1-4aN0M0 urothelial BCat nine centers. LN-densitywas calculated as the ratio of the number of positive LNsx100% to the number of LNs removed. The optimal LN-density cut-off value was defined by creating a time-dependent receiver operating characteristic (ROC) curve in pN patients. Univariable and multivariable Cox' regression analyses were used to assess the effect of conventional Tumor Nodes Metastasis (TNM) nodal staging system, LN-density and other LN-related variables on DSS in the pN-positive cohort. RESULTS: Of the 1169 patients, 463 (39.6%) patients had LN-involvement. The area under the ROC curve was 0.60 and the cut-off for LN-density was set at 20%, 223 of the pN-positive patients (48.2%) had a LN-density >= 20%. In multivariable models, the number of LN-metastases (HR 1.03, p = 0.005) and LN-density, either as continuous (HR 1.01, p = 0.013) or as categorical variable (HR 1.37, p = 0.014), were independently associated with worse DSS, whereas pN-stage was not. CONCLUSIONS: LN-density >= 20% was an independent predictor of worse DSS in BC patients with LN-involvement at RC. The integration of LN-density and other LN-parameters rather than only conventional pN-stage may contribute to a more refined risk-stratification in BC patients with nodal involvement.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | EXTRANODAL EXTENSION; CARCINOMA; LYMPHADENECTOMY; CHEMOTHERAPY; METASTASES; SYSTEM; Bladder cancer; radical cystectomy; survival; lymph node density; urothelial neoplasm |
| Subjects: | 600 Technology > 610 Medical sciences Medicine |
| Divisions: | Medicine > Lehrstuhl für Urologie |
| Depositing User: | Dr. Gernot Deinzer |
| Date Deposited: | 20 Aug 2025 09:01 |
| Last Modified: | 20 Aug 2025 09:01 |
| URI: | https://pred.uni-regensburg.de/id/eprint/65553 |
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