OBJECTIVE: To summarize the efficacy of pelvic lymph node dissection for radical bladder cancer and to discuss its clinical significance.
Methods: 95 patients, 76 males and 19 females, aged 25-78 years, 49 cases of primary and 46 cases of recurrence, 87 cases of pathologically classified uroepithelial carcinoma, 5 cases of adenocarcinoma and 3 cases of squamous carcinoma. Pathological classification of uroepithelial carcinoma: G1 17 cases; G2 39 cases; G3 31 cases. Pathological stage Ta-1 in 10 cases, T2 in 54 cases, T3 in 26 cases, and T4 in 5 cases. All patients underwent standard bilateral regional pelvic lymph node dissection during radical cystectomy for bladder cancer, and the lymph nodes dissected included bilateral internal and external iliac and closed foramen lymph nodes.
RESULTS: The average time of 95 lymph node dissection procedures was 20 min, the average bleeding volume was 25 ml, and no important vascular or nerve injury occurred during the procedure. The number of lymph nodes cleared ranged from 1 to 20, with a mean of 10, and the positive lymph node rate was 17.9% (17/95). The recent postoperative complications were 12.6% (12/95), including pelvic lymphatic fistula, pelvic infection, and scrotal or lower limb edema. Postoperative follow-up ranged from 3 to 64 months, with a median time of 34 months, 16 deaths, and a 3-year survival rate of 84.5%.
CONCLUSION: Standard bilateral regional pelvic lymph node dissection in patients undergoing radical bladder cancer improves the accuracy of staging and patient survival without serious complications, and is a safe and effective operation.