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International Journal of Surgical Oncology
Volume 2011 (2011), Article ID 758189, 9 pages
http://dx.doi.org/10.1155/2011/758189
Review Article

Lymphadenectomy in Management of Invasive Bladder Cancer

Department of Urology, UT Southwestern Medical Center at Dallas, J8-130 5323 Harry Hines Boulevard Dallas, TX 75390-9110, USA

Received 16 December 2010; Accepted 29 March 2011

Academic Editor: Vahit Ozmen

Copyright © 2011 Ramy F. Youssef and Ganesh V. Raj. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Radical cystectomy with pelvic lymphadenectomy represents the gold standard for treatment of muscle-invasive bladder cancer. Extent of the lymph node dissection and lymph node involvement during radical cystectomy are the most powerful prognostic factors associated with poor oncological outcome. However, the optimal boundaries of the lymph node dissection during a radical cystectomy are controversial. The published literature based mostly on retrospective studies suggests that increasing the number of nodes excised may have therapeutic and diagnostic benefits without significantly increasing the surgical morbidity. These conclusions are, however, influenced by selection and surgeon biases, inconsistencies in the quality of the surgery, and node count variability. In this paper, we establish the current understanding about the utility of lymphadenectomy during a radical cystectomy for muscle-invasive bladder cancer.