caa a22 4500 445334126 CHVBK 20180317142747.0 cr unu---uuuuu 170323e20110701xx s 000 0 eng 10.1245/s10434-010-1538-6 doi (NATIONALLICENCE)springer-10.1245/s10434-010-1538-6 Association Between the Number of Dissected Lymph Nodes During Pelvic Lymphadenectomy and Cancer-Specific Survival in Patients with Lymph Node-Negative Urothelial Carcinoma of the Bladder Undergoing Radical Cystectomy [Elektronische Daten] [Matthias May, Edwin Herrmann, Christian Bolenz, Sabine Brookman-May, Arne Tiemann, Rudolf Moritz, Hans-Martin Fritsche, Maximilian Burger, Lutz Trojan, Maurice Michel, Christian Wülfing, Stefan Müller, Jörg Ellinger, Alexander Buchner, Christian Stief, Derya Tilki, Wolf Wieland, Christian Gilfrich, Thomas Höfner, Markus Hohenfellner, Axel Haferkamp, Jan Roigas, Mario Zacharias, Patrick Bastian] Background: A larger number of dissected lymph nodes (LN) during pelvic lymphadenectomy in patients with muscle-invasive transitional-cell carcinoma of the bladder treated by radical cystectomy (RC) is crucial for exact tumor staging and is associated with a positive oncological outcome. Methods: Clinical and pathological records of 1291 patients undergoing RC due to LN-negative transitional-cell carcinoma of the bladder were summarized and evaluated in a multi-institutional database. The number of removed LNs and the presence or absence of lymphovascular invasion were assessed. On the basis of multivariate Cox regression analyses, a threshold number of removed LNs was defined that exerted an independent influence on cancer-specific survival (CSS). Results: In multivariate Cox regression models for different numbers of removed LNs, a statistically significant enhancement of CSS could be demonstrated for a LN count of 16. Furthermore, the integration of the dichotomized LN count of 16 resulted in a statistically significantly enhanced predictive ability of the model for CSS. Patients with <16 and ≥16 removed LNs showed CSS rates after 5years of 72% and 83%, respectively (P=0.01). In addition, age, sex, pT stage, and lymphovascular invasion had independent influences on CSS in every Cox regression model. Conclusions: In patients undergoing RC, removal of a higher LN count is associated with an improved oncological outcome. The information resulting from an assessment of lymphovascular invasion and an extended lymphadenectomy is critical for stratification of risk groups and identification of patients who might benefit from adjuvant treatment. Society of Surgical Oncology, 2011 May Matthias Department of Urology, St. Elisabeth Klinikum Straubing, Straubing, Germany aut Herrmann Edwin Urologische Universitätsklinik, Universität Münster, Münster, Germany aut Bolenz Christian Urologische Universitätsklinik, Universität Heidelberg, Mannheim, Germany aut Brookman-May Sabine Klinik für Urologie der Universität Regensburg, Caritas Krankenhaus St. Josef, Regensburg, Germany aut Tiemann Arne Urologische Universitätsklinik, Universität Münster, Münster, Germany aut Moritz Rudolf Urologische Universitätsklinik, Universität Münster, Münster, Germany aut Fritsche Hans-Martin Klinik für Urologie der Universität Regensburg, Caritas Krankenhaus St. Josef, Regensburg, Germany aut Burger Maximilian Klinik für Urologie der Universität Regensburg, Caritas Krankenhaus St. Josef, Regensburg, Germany aut Trojan Lutz Urologische Universitätsklinik, Universität Heidelberg, Mannheim, Germany aut Michel Maurice Urologische Universitätsklinik, Universität Heidelberg, Mannheim, Germany aut Wülfing Christian Urologische Universitätsklinik, Universität Münster, Münster, Germany aut Müller Stefan Urologische Universitätsklinik, Universität Bonn, Bonn, Germany aut Ellinger Jörg Urologische Universitätsklinik, Universität Bonn, Bonn, Germany aut Buchner Alexander Urologische Universitätsklinik, LMU München, München, Germany aut Stief Christian Urologische Universitätsklinik, LMU München, München, Germany aut Tilki Derya Urologische Universitätsklinik, LMU München, München, Germany aut Wieland Wolf Klinik für Urologie der Universität Regensburg, Caritas Krankenhaus St. Josef, Regensburg, Germany aut Gilfrich Christian Department of Urology, St. Elisabeth Klinikum Straubing, Straubing, Germany aut Höfner Thomas Urologische Universitätsklinik, Universität Heidelberg, Heidelberg, Germany aut Hohenfellner Markus Urologische Universitätsklinik, Universität Heidelberg, Heidelberg, Germany aut Haferkamp Axel Urologische Universitätsklinik, Universität Frankfurt/Main, Frankfurt/Main, Germany aut Roigas Jan Urologische Klinik, Vivantes Kliniken Am Urban und Im Friedrichshain Berlin, Berlin, Germany aut Zacharias Mario Urologische Klinik, Vivantes Klinikum AVK Berlin, Berlin, Germany aut Bastian Patrick Urologische Universitätsklinik, LMU München, München, Germany aut Annals of Surgical Oncology Springer-Verlag 18/7(2011-07-01), 2018-2025 1068-9265 18:7<2018 2011 18 10434 https://doi.org/10.1245/s10434-010-1538-6 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1245/s10434-010-1538-6 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- May Matthias Department of Urology, St. Elisabeth Klinikum Straubing, Straubing, Germany aut NATIONALLICENCE 700 1- Herrmann Edwin Urologische Universitätsklinik, Universität Münster, Münster, Germany aut NATIONALLICENCE 700 1- Bolenz Christian Urologische Universitätsklinik, Universität Heidelberg, Mannheim, Germany aut NATIONALLICENCE 700 1- Brookman-May Sabine Klinik für Urologie der Universität Regensburg, Caritas Krankenhaus St. Josef, Regensburg, Germany aut NATIONALLICENCE 700 1- Tiemann Arne Urologische Universitätsklinik, Universität Münster, Münster, Germany aut NATIONALLICENCE 700 1- Moritz Rudolf Urologische Universitätsklinik, Universität Münster, Münster, Germany aut NATIONALLICENCE 700 1- Fritsche Hans-Martin Klinik für Urologie der Universität Regensburg, Caritas Krankenhaus St. Josef, Regensburg, Germany aut NATIONALLICENCE 700 1- Burger Maximilian Klinik für Urologie der Universität Regensburg, Caritas Krankenhaus St. Josef, Regensburg, Germany aut NATIONALLICENCE 700 1- Trojan Lutz Urologische Universitätsklinik, Universität Heidelberg, Mannheim, Germany aut NATIONALLICENCE 700 1- Michel Maurice Urologische Universitätsklinik, Universität Heidelberg, Mannheim, Germany aut NATIONALLICENCE 700 1- Wülfing Christian Urologische Universitätsklinik, Universität Münster, Münster, Germany aut NATIONALLICENCE 700 1- Müller Stefan Urologische Universitätsklinik, Universität Bonn, Bonn, Germany aut NATIONALLICENCE 700 1- Ellinger Jörg Urologische Universitätsklinik, Universität Bonn, Bonn, Germany aut NATIONALLICENCE 700 1- Buchner Alexander Urologische Universitätsklinik, LMU München, München, Germany aut NATIONALLICENCE 700 1- Stief Christian Urologische Universitätsklinik, LMU München, München, Germany aut NATIONALLICENCE 700 1- Tilki Derya Urologische Universitätsklinik, LMU München, München, Germany aut NATIONALLICENCE 700 1- Wieland Wolf Klinik für Urologie der Universität Regensburg, Caritas Krankenhaus St. Josef, Regensburg, Germany aut NATIONALLICENCE 700 1- Gilfrich Christian Department of Urology, St. Elisabeth Klinikum Straubing, Straubing, Germany aut NATIONALLICENCE 700 1- Höfner Thomas Urologische Universitätsklinik, Universität Heidelberg, Heidelberg, Germany aut NATIONALLICENCE 700 1- Hohenfellner Markus Urologische Universitätsklinik, Universität Heidelberg, Heidelberg, Germany aut NATIONALLICENCE 700 1- Haferkamp Axel Urologische Universitätsklinik, Universität Frankfurt/Main, Frankfurt/Main, Germany aut NATIONALLICENCE 700 1- Roigas Jan Urologische Klinik, Vivantes Kliniken Am Urban und Im Friedrichshain Berlin, Berlin, Germany aut NATIONALLICENCE 700 1- Zacharias Mario Urologische Klinik, Vivantes Klinikum AVK Berlin, Berlin, Germany aut NATIONALLICENCE 700 1- Bastian Patrick Urologische Universitätsklinik, LMU München, München, Germany aut NATIONALLICENCE 773 0- Annals of Surgical Oncology Springer-Verlag 18/7(2011-07-01), 2018-2025 1068-9265 18:7<2018 2011 18 10434 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer