Stein-膀胱癌淋巴清扫-英文课件.pptVIP

The Role of Lymphadenectomy in Bladder Cancer John P. Stein, M.D. University of Southern California Keck School of Medicine, Norris Comprehensive Cancer Center, Los Angeles CA HIGH-GRADE, INVASIVE BLADDER CANCER Reality “Invasive bladder cancer is a lethal disease.” USC BLADDER CANCER EXPERIENCE  Rationale for Cystectomy Best survival results Lowest local recurrence rates Improved morbidity and mortality Urinary reconstruction has improved quality of life (continent and orthotopic diversion) Equally effective forms of therapy have not emerged USC/ NORRIS BLADDER CANCER EXPERIENCERecurrence-Free Survival of 1054 Patients Stratified by Lymph Node Status (LN+ vs. LN-) Incidence of Lymph Node Metastases at Cystectomy Author Years Total # Pts LN+ Poulsen ‘90-’97 191 50 (26%) Vieweg ‘80-’90 686 193 (28%) Leissner ‘99-’02 290 81 (28%) Stein ‘71-’97 1054 246 (24%) Totals 2221 570 (25%) Risk Factors for Lymph Node Metastases Following Radical Cystectomy: The Concept of Lymph Node Density John P. Stein, M.D. University of Southern California Keck School of Medicine, Norris Comprehensive Cancer Center, Los Angeles CA USC Radical Cystectomy Experience: Long-Term Results in 1,054 PatientsJ. Clin. Oncol., 19: 666, 2001. Radical cystectomy with BPLND 24% of patients LN+ disease Risk factors include: p-stage # of LN involved USC Radical Cystectomy Experience: Long-Term Results in 1,054 PatientsJ. Clin. Oncol., 19: 666, 2001. Radical cystectomy with BPLND 24% of patients LN+ disease Risk factors include: p-stage # of LN involved USC Radical Cystectomy Experience: Long-Term Results in 1,054 PatientsJ. Clin. Oncol., 19: 666, 2001. Radical cystectomy with BPLND 24% of patients LN+ disease Risk factors include: p-stage # of LN involved USC Radical Cystectomy Experience: Long-Term Results in 1,054 PatientsJ. Clin. Oncol., 19: 666, 2001. Radical cystectomy with BPLND 24% of patients LN+ d