ABSTRACT

Radical cystectomy with pelvic lymph node dissection (PLND) is the preferred treatment for invasive bladder cancer. Approximately 25% of patients with stages T1-T4 N0M0 harbour metastatic lymph nodes at the time of radical cystectomy. Radical cystectomy with PLND not only results in the best disease-free term survival rates, but also provides the most accurate disease staging and most effective local symptom control. Despite variation in the extent of superior boundary, dissection up to the aortic bifurcation is a uniform extent in all the studies. However, the extend of LND has not been standardized and its relevance for staging and prognosis is stil not clear. This is largely due to the absence of any published randomized controlled trials comparing standart to extended PLND in cystectomy patients.