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Fewer tumour draining sentinel nodes in patients with progressing muscle invasive bladder cancer, after neoadjuvant chemotherapy and radical cystectomy
Umea Univ, Sweden.
Umea Univ, Sweden; Stockholm South Gen Hosp, Sweden.
Umea Univ, Sweden; Sundsvall Hosp, Sweden.
Vastmanland Hosp, Sweden.
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2019 (English)In: World journal of urology, ISSN 0724-4983, E-ISSN 1433-8726Article in journal (Refereed) Epub ahead of print
Abstract [en]

Purpose To examine the relationship between the number of tumour draining sentinel nodes (SNs) and pathoanatomical outcomes, in muscle-invasive bladder cancer (MIBC), in patients undergoing neoadjuvant chemotherapy (NAC) and radical cystectomy (RC). Materials and Methods In an ongoing prospective multicenter study, we included 230 patients with suspected urothelial MIBC from ten Swedish urological centers. All underwent TURb and clinical staging. From the cohort, 116 patients with urothelial MIBC; cT2-cT4aN0M0, underwent radical cystectomy (RC) and lymphadenectomy with SN-detection (SNd). 83 patients received cisplatin-based NAC and 33 were NAC-naive. The number and locations of detected SNs and non-SNs were recorded for each patient. The NAC treated patients were categorized by pathoanatomical outcomes post-RC into three groups: complete responders (CR), stable disease (SD) and progressive disease (PD). Selected covariates with possible impact on SN-yield were tested in uni -and multivariate analyses for NAC-treated patients only. Results In NAC treated patients, the mean number of SNs was significantly higher in CR patients (3.3) and SD patients (3.6) compared with PD patients (1.4) (p = 0.034). In a linear multivariate regression model, the number of harvested nodes was the only independent variable that affected the number of SNs (p = 0.0004). Conclusions The number of tumor-draining SNs in NAC-treated patients was significantly lower in patients with progressive disease.

Place, publisher, year, edition, pages
SPRINGER , 2019.
Keywords [en]
Urinary bladder neoplasms; Neoadjuvant therapy; Cisplatin; Sentinel lymph node biopsy; Cystectomy
National Category
Urology and Nephrology
Identifiers
URN: urn:nbn:se:liu:diva-162749DOI: 10.1007/s00345-019-03025-wISI: 000498743100002PubMedID: 31760442OAI: oai:DiVA.org:liu-162749DiVA, id: diva2:1380370
Note

Funding Agencies|Umea University; Swedish Cancer SocietySwedish Cancer Society; Wallenberg Foundation; Swedish Medical Research CouncilSwedish Medical Research Council (SMRC); Regionala forskningsradet i Uppsala-Orebroregionen (RFR in Uppsala-Orebro); Swedish Research Council funding for clinical research in medicine (ALF) in Vasterbotten, VLL, Sweden; Cancer Research Foundations of Radiumhemmet; Cancer Research Foundation in Norrland, Umea, Sweden

Available from: 2019-12-18 Created: 2019-12-18 Last updated: 2020-01-22

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Huge, YlvaAbdul-Sattar Aljabery, Firas
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