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Outcomes and prognostic factors in patients with a single lymph node metastasis at time of radical cystectomy.

Standard

Outcomes and prognostic factors in patients with a single lymph node metastasis at time of radical cystectomy. / Rink, Michael; Hansen, Jens; Cha, Eugene K; Green, David A; Babjuk, Marko; Svatek, Robert S; Xylinas, Evanguelos; Tagawa, Scott T; Faison, Talia; Novara, Giacomo; Karakiewicz, Pierre I; Daneshmand, Siamak; Lotan, Yair; Kassouf, Wassim; Fritsche, Hans-Martin; Pycha, Armin; Comploj, Evi; Tilki, Derya; Bastian, Patrick J; Chun, Felix K; Dahlem, Roland; Scherr, Douglas S; Shariat, Shahrokh F.

In: BJU INT, Vol. 111, No. 1, 1, 2013, p. 74-84.

Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review

Harvard

Rink, M, Hansen, J, Cha, EK, Green, DA, Babjuk, M, Svatek, RS, Xylinas, E, Tagawa, ST, Faison, T, Novara, G, Karakiewicz, PI, Daneshmand, S, Lotan, Y, Kassouf, W, Fritsche, H-M, Pycha, A, Comploj, E, Tilki, D, Bastian, PJ, Chun, FK, Dahlem, R, Scherr, DS & Shariat, SF 2013, 'Outcomes and prognostic factors in patients with a single lymph node metastasis at time of radical cystectomy.', BJU INT, vol. 111, no. 1, 1, pp. 74-84. https://doi.org/10.1111/j.1464-410X.2012.11356.x

APA

Rink, M., Hansen, J., Cha, E. K., Green, D. A., Babjuk, M., Svatek, R. S., Xylinas, E., Tagawa, S. T., Faison, T., Novara, G., Karakiewicz, P. I., Daneshmand, S., Lotan, Y., Kassouf, W., Fritsche, H-M., Pycha, A., Comploj, E., Tilki, D., Bastian, P. J., ... Shariat, S. F. (2013). Outcomes and prognostic factors in patients with a single lymph node metastasis at time of radical cystectomy. BJU INT, 111(1), 74-84. [1]. https://doi.org/10.1111/j.1464-410X.2012.11356.x

Vancouver

Rink M, Hansen J, Cha EK, Green DA, Babjuk M, Svatek RS et al. Outcomes and prognostic factors in patients with a single lymph node metastasis at time of radical cystectomy. BJU INT. 2013;111(1):74-84. 1. https://doi.org/10.1111/j.1464-410X.2012.11356.x

Bibtex

@article{b0a719fedc034f16b800e0b4c29eebea,
title = "Outcomes and prognostic factors in patients with a single lymph node metastasis at time of radical cystectomy.",
abstract = "OBJECTIVES: To identify clinicopathological factors that predict outcomes in patients with a single lymph node (LN) metastasis (pN1) treated with radical cystectomy (RC) for urothelial carcinoma of the bladder (UCB). LN metastasis is an established predictor of clinical outcomes in patients. While most patients with large LN burden experience disease recurrence, lymphadenectomy can be curative in patients with pN1 disease.PATIENTS AND METHODS: We analysed 381 patients with pN1 UCB from a multi-institutional cohort of 4335 patients with UCB treated with RC and lymphadenectomy without preoperative chemo- or radiotherapy. Subgroup analyses were performed for patients with ≥9 LNs removed and according to adjuvant chemotherapy administration (n = 215).RESULTS: The median (interquartile range, IQR) LN number was 15 (19) and the median (IQR) LN density was 6.7 (7.5)%. Within a median follow-up of 41 months, the mean (+/- SD) 2- and 5-year cancer-specific survival (CSS) rates were 55 (3)% and 46 (3)%, respectively. On multivariable analysis that adjusted for the effects of standard clinicopathological features, female gender (hazard ratio [HR] 1.48, P = 0.023), higher tumour stage (HR 1.68, P = 0.007), positive soft tissue surgical margin (STSM; HR 2.06, P = 0.004), higher LN density (HR 2.99, P = 0.025) and absence of adjuvant chemotherapy (HR 0.70, P = 0.026) were independently associated with CSS. In subgroup analyses of patients with ≥9 LNs removed, tumour stage and STSM status remained independent predictors for CSS (P = 0.009 and P < 0.001, respectively).CONCLUSIONS: About half of the patients with pN1 UCB died from UCB within 5 years of RC. Pathological stage and STSM status are strong predictors for outcomes. Accurate prediction of the individual risk of CSS may help risk stratifying pN1 UCB in order to help improve clinical-decision making. Patients with pN1 UCB presenting with additional unfavourable risk factors need a closer follow-up scheduling and might receive adjuvant therapy.",
keywords = "Adult, Humans, Male, Aged, Female, Middle Aged, Aged, 80 and over, Adolescent, Young Adult, Treatment Outcome, Epidemiologic Methods, Child, Lymphatic Metastasis, Child, Preschool, Infant, Carcinoma in Situ/drug therapy/mortality/pathology/*surgery, Chemotherapy, Adjuvant/mortality, Cystectomy/*methods/mortality, Lymph Node Excision/mortality, Neoplasm Recurrence, Local/mortality, Urinary Bladder Neoplasms/drug therapy/mortality/pathology/*surgery, Adult, Humans, Male, Aged, Female, Middle Aged, Aged, 80 and over, Adolescent, Young Adult, Treatment Outcome, Epidemiologic Methods, Child, Lymphatic Metastasis, Child, Preschool, Infant, Carcinoma in Situ/drug therapy/mortality/pathology/*surgery, Chemotherapy, Adjuvant/mortality, Cystectomy/*methods/mortality, Lymph Node Excision/mortality, Neoplasm Recurrence, Local/mortality, Urinary Bladder Neoplasms/drug therapy/mortality/pathology/*surgery",
author = "Michael Rink and Jens Hansen and Cha, {Eugene K} and Green, {David A} and Marko Babjuk and Svatek, {Robert S} and Evanguelos Xylinas and Tagawa, {Scott T} and Talia Faison and Giacomo Novara and Karakiewicz, {Pierre I} and Siamak Daneshmand and Yair Lotan and Wassim Kassouf and Hans-Martin Fritsche and Armin Pycha and Evi Comploj and Derya Tilki and Bastian, {Patrick J} and Chun, {Felix K} and Roland Dahlem and Scherr, {Douglas S} and Shariat, {Shahrokh F}",
note = "{\textcopyright} 2012 The Authors BJU International {\textcopyright} 2012 BJU International.",
year = "2013",
doi = "10.1111/j.1464-410X.2012.11356.x",
language = "English",
volume = "111",
pages = "74--84",
journal = "BJU INT",
issn = "1464-4096",
publisher = "Wiley-Blackwell",
number = "1",

}

RIS

TY - JOUR

T1 - Outcomes and prognostic factors in patients with a single lymph node metastasis at time of radical cystectomy.

AU - Rink, Michael

AU - Hansen, Jens

AU - Cha, Eugene K

AU - Green, David A

AU - Babjuk, Marko

AU - Svatek, Robert S

AU - Xylinas, Evanguelos

AU - Tagawa, Scott T

AU - Faison, Talia

AU - Novara, Giacomo

AU - Karakiewicz, Pierre I

AU - Daneshmand, Siamak

AU - Lotan, Yair

AU - Kassouf, Wassim

AU - Fritsche, Hans-Martin

AU - Pycha, Armin

AU - Comploj, Evi

AU - Tilki, Derya

AU - Bastian, Patrick J

AU - Chun, Felix K

AU - Dahlem, Roland

AU - Scherr, Douglas S

AU - Shariat, Shahrokh F

N1 - © 2012 The Authors BJU International © 2012 BJU International.

PY - 2013

Y1 - 2013

N2 - OBJECTIVES: To identify clinicopathological factors that predict outcomes in patients with a single lymph node (LN) metastasis (pN1) treated with radical cystectomy (RC) for urothelial carcinoma of the bladder (UCB). LN metastasis is an established predictor of clinical outcomes in patients. While most patients with large LN burden experience disease recurrence, lymphadenectomy can be curative in patients with pN1 disease.PATIENTS AND METHODS: We analysed 381 patients with pN1 UCB from a multi-institutional cohort of 4335 patients with UCB treated with RC and lymphadenectomy without preoperative chemo- or radiotherapy. Subgroup analyses were performed for patients with ≥9 LNs removed and according to adjuvant chemotherapy administration (n = 215).RESULTS: The median (interquartile range, IQR) LN number was 15 (19) and the median (IQR) LN density was 6.7 (7.5)%. Within a median follow-up of 41 months, the mean (+/- SD) 2- and 5-year cancer-specific survival (CSS) rates were 55 (3)% and 46 (3)%, respectively. On multivariable analysis that adjusted for the effects of standard clinicopathological features, female gender (hazard ratio [HR] 1.48, P = 0.023), higher tumour stage (HR 1.68, P = 0.007), positive soft tissue surgical margin (STSM; HR 2.06, P = 0.004), higher LN density (HR 2.99, P = 0.025) and absence of adjuvant chemotherapy (HR 0.70, P = 0.026) were independently associated with CSS. In subgroup analyses of patients with ≥9 LNs removed, tumour stage and STSM status remained independent predictors for CSS (P = 0.009 and P < 0.001, respectively).CONCLUSIONS: About half of the patients with pN1 UCB died from UCB within 5 years of RC. Pathological stage and STSM status are strong predictors for outcomes. Accurate prediction of the individual risk of CSS may help risk stratifying pN1 UCB in order to help improve clinical-decision making. Patients with pN1 UCB presenting with additional unfavourable risk factors need a closer follow-up scheduling and might receive adjuvant therapy.

AB - OBJECTIVES: To identify clinicopathological factors that predict outcomes in patients with a single lymph node (LN) metastasis (pN1) treated with radical cystectomy (RC) for urothelial carcinoma of the bladder (UCB). LN metastasis is an established predictor of clinical outcomes in patients. While most patients with large LN burden experience disease recurrence, lymphadenectomy can be curative in patients with pN1 disease.PATIENTS AND METHODS: We analysed 381 patients with pN1 UCB from a multi-institutional cohort of 4335 patients with UCB treated with RC and lymphadenectomy without preoperative chemo- or radiotherapy. Subgroup analyses were performed for patients with ≥9 LNs removed and according to adjuvant chemotherapy administration (n = 215).RESULTS: The median (interquartile range, IQR) LN number was 15 (19) and the median (IQR) LN density was 6.7 (7.5)%. Within a median follow-up of 41 months, the mean (+/- SD) 2- and 5-year cancer-specific survival (CSS) rates were 55 (3)% and 46 (3)%, respectively. On multivariable analysis that adjusted for the effects of standard clinicopathological features, female gender (hazard ratio [HR] 1.48, P = 0.023), higher tumour stage (HR 1.68, P = 0.007), positive soft tissue surgical margin (STSM; HR 2.06, P = 0.004), higher LN density (HR 2.99, P = 0.025) and absence of adjuvant chemotherapy (HR 0.70, P = 0.026) were independently associated with CSS. In subgroup analyses of patients with ≥9 LNs removed, tumour stage and STSM status remained independent predictors for CSS (P = 0.009 and P < 0.001, respectively).CONCLUSIONS: About half of the patients with pN1 UCB died from UCB within 5 years of RC. Pathological stage and STSM status are strong predictors for outcomes. Accurate prediction of the individual risk of CSS may help risk stratifying pN1 UCB in order to help improve clinical-decision making. Patients with pN1 UCB presenting with additional unfavourable risk factors need a closer follow-up scheduling and might receive adjuvant therapy.

KW - Adult

KW - Humans

KW - Male

KW - Aged

KW - Female

KW - Middle Aged

KW - Aged, 80 and over

KW - Adolescent

KW - Young Adult

KW - Treatment Outcome

KW - Epidemiologic Methods

KW - Child

KW - Lymphatic Metastasis

KW - Child, Preschool

KW - Infant

KW - Carcinoma in Situ/drug therapy/mortality/pathology/surgery

KW - Chemotherapy, Adjuvant/mortality

KW - Cystectomy/methods/mortality

KW - Lymph Node Excision/mortality

KW - Neoplasm Recurrence, Local/mortality

KW - Urinary Bladder Neoplasms/drug therapy/mortality/pathology/surgery

KW - Adult

KW - Humans

KW - Male

KW - Aged

KW - Female

KW - Middle Aged

KW - Aged, 80 and over

KW - Adolescent

KW - Young Adult

KW - Treatment Outcome

KW - Epidemiologic Methods

KW - Child

KW - Lymphatic Metastasis

KW - Child, Preschool

KW - Infant

KW - Carcinoma in Situ/drug therapy/mortality/pathology/surgery

KW - Chemotherapy, Adjuvant/mortality

KW - Cystectomy/methods/mortality

KW - Lymph Node Excision/mortality

KW - Neoplasm Recurrence, Local/mortality

KW - Urinary Bladder Neoplasms/drug therapy/mortality/pathology/surgery

U2 - 10.1111/j.1464-410X.2012.11356.x

DO - 10.1111/j.1464-410X.2012.11356.x

M3 - SCORING: Journal article

C2 - 22809039

VL - 111

SP - 74

EP - 84

JO - BJU INT

JF - BJU INT

SN - 1464-4096

IS - 1

M1 - 1

ER -