Preprint Review Version 1 Preserved in Portico This version is not peer-reviewed

Management of Bladder Cancer Patients with Clinical Evidence of Lymph Node Invasion (cN+)

Bartosz Małkiewicz
* ORCID logo ,
Adam Gurwin
* ,
Jakub Karwacki
,
Krystian Nagi
,
Klaudia Knecht-Gurwin
,
Krzysztof Hober
,
Magdalena Łyko
,
Kamil Kowalczyk
,
Wojciech Krajewski
,
Anna Kołodziej
,
Tomasz Szydełko
Version 1 : Received: 23 August 2022 / Approved: 25 August 2022 / Online: 25 August 2022 (10:05:05 CEST)

A peer-reviewed article of this Preprint also exists.

Małkiewicz, B.; Gurwin, A.; Karwacki, J.; Nagi, K.; Knecht-Gurwin, K.; Hober, K.; Łyko, M.; Kowalczyk, K.; Krajewski, W.; Kołodziej, A.; Szydełko, T. Management of Bladder Cancer Patients with Clinical Evidence of Lymph Node Invasion (cN+). Cancers 2022, 14, 5286. Małkiewicz, B.; Gurwin, A.; Karwacki, J.; Nagi, K.; Knecht-Gurwin, K.; Hober, K.; Łyko, M.; Kowalczyk, K.; Krajewski, W.; Kołodziej, A.; Szydełko, T. Management of Bladder Cancer Patients with Clinical Evidence of Lymph Node Invasion (cN+). Cancers 2022, 14, 5286.

Abstract

The purpose of this review is to present the current knowledge about the diagnostic and treatment options in bladder cancer (BCa) patients with clinically positive lymph nodes (cN+). In this review compaction of CT and MRI performance in preoperative prediction of lymph node invasion (LNI) in BCa patients was presented, along with other diagnostic methods. Most scientific societies do not distinguish cN+ patients in their guidelines, recommendations concern muscle-invasive bladder cancer (MIBC) and differ between associations. Currently, the standard treatment of patients with MIBC is radical cystectomy (RC) with bilateral pelvic lymph node dis-section (PLND). The template of PLND and its therapeutic value remain debatable. Moreover, most guidelines recommend neoadjuvant chemotherapy (NAC). However, there is still lack of definitive evidence of the superiority of neoadjuvant chemotherapy over adjuvant chemotherapy. Nevertheless, the curative treatment that provides the best long-term survival in cN+ patients is a multimodal approach with a combination of chemotherapy and RC. Recent studies demonstrate the growing importance of immunotherapy. Special attention should be paid to cN+ BCa patients as the oncological outcomes are significantly worse for this group.

Keywords

bladder cancer; clinically positive lymph nodes; diagnosis; treatment; lymphadenectomy

Subject

Medicine and Pharmacology, Urology and Nephrology

Copyright: 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.

Download PDF

Comments (0)

We encourage comments and feedback from a broad range of readers. See criteria for comments and our Diversity statement.

Leave a public comment
Send a private comment to the author(s)
* All users must log in before leaving a comment
Views 0
Downloads 0
Comments 0
Metrics 0
Get PDF Cite Share 0
Bookmark BibSonomy Mendeley Reddit Delicious
×
Alerts
Notify me about updates to this article or when a peer-reviewed version is published.
We use cookies on our website to ensure you get the best experience.
Read more about our cookies here.