MP55-07 SIGNIFICANCE OF LYMPH NODE INVOLVEMENT IN VARIANT HISTOLOGY UROTHELIAL BLADDER CANCER (2014)

You have accessJournal of UrologyBladder Cancer: Invasive II1 Apr 2014MP55-07 SIGNIFICANCE OF LYMPH NODE INVOLVEMENT IN VARIANT HISTOLOGY UROTHELIAL BLADDER CANCER M Francesca Monn, Hristos Z. Kaimakliotis, Jose A. Pedrosa, K Clint Cary, Paul T. Gellhaus, Kevin Rice, Timothy A. Masterson, Thomas A. Gardner, Richard S. Foster, Richard Bihrle, Liang Cheng, and Michael O. Koch M Francesca MonnM Francesca Monn More articles by this author , Hristos Z. KaimakliotisHristos Z. Kaimakliotis More articles by this author , Jose A. PedrosaJose A. Pedrosa More articles by this author , K Clint CaryK Clint Cary More articles by this author , Paul T. GellhausPaul T. Gellhaus More articles by this author , Kevin RiceKevin Rice More articles by this author , Timothy A. MastersonTimothy A. Masterson More articles by this author , Thomas A. GardnerThomas A. Gardner More articles by this author , Richard S. FosterRichard S. Foster More articles by this author , Richard BihrleRichard Bihrle More articles by this author , Liang ChengLiang Cheng More articles by this author , and Michael O. KochMichael O. Koch More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2014.02.1555AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail Introduction and Objectives Identification of lymph node involvement and extent thereof in urothelial bladder cancer (UC) is a clinical prognosticator of poor outcome. Micropapillary (MPV) and plasmacytoid (PCV) variants are typically considered more aggressive subsets of UC when compared to squamous differentiation variant (SQD) and non-variant (NV) UC. We seek to examine if there is a difference in characteristics with relation to their extent and propensity for lymph node positive disease (LN+). Methods A retrospective cohort analysis using the Indiana University Bladder Cancer Database was conducted on all patients undergoing radical cystectomy for curative intent with urothelial carcinoma since 2008. Examination of patients with LN+ was focused on comparing lymph node density, which was defined as the # +LN/total # LN removed. Chi-squared test and ANOVA were used for categorical and continuous variable analysis. Results We identified 592 patients who underwent lymph node dissection (LND) during cystectomy for UC of which 24.2% had LN+. Among patients with non-variant UC the incidence of LN+ was 18.1%, compared to 23.2% (n=16/69) in SQD, 65.4% (n=17/26) in MPV and 73.9% (n=17/23) in PCV, (p<0.001). Average LN yield in all LND patients was 24.33 nodes, with a mean density of 24% in LN+ cases. There was no difference in LN yield between the groups (p=0.8543). Mean (median) lymph node density for NV, SQD, PCV and MPV was 20.9% (11.8%), 19.6% (12.8%), 33.7% (21.1%), and 36.1% (23.3%) respectively (p<0.001) (Chart). Of the 69 patients who underwent neo-adjuvant chemotherapy, 10% of NV (n=5/51) had +LN on final pathology, as did 20% of SQD (n=1/5), 60% of MPV (n=3/5) and 75% of PCV (n=3/4) (p=0.001). Conclusions MPV and PCV seem to behave similarly and have an increased incidence of LN+ and higher LN density on final pathology at cystectomy compared to NV patients. However, non-variant UC and SQD behaved more similar to one another with regard to LN+ status. MPV and PCV are indeed aggressive variants and treatment plans should be accordingly similar. © 2014FiguresReferencesRelatedDetails Volume 191Issue 4SApril 2014Page: e557-e558 Advertisement Copyright & Permissions© 2014MetricsAuthor Information M Francesca Monn More articles by this author Hristos Z. Kaimakliotis More articles by this author Jose A. Pedrosa More articles by this author K Clint Cary More articles by this author Paul T. Gellhaus More articles by this author Kevin Rice More articles by this author Timothy A. Masterson More articles by this author Thomas A. Gardner More articles by this author Richard S. Foster More articles by this author Richard Bihrle More articles by this author Liang Cheng More articles by this author Michael O. Koch More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...