Outcome of patients with grossly node positive bladder cancer after pelviclymph node dissection and radical cystectomy

Purpose: Should the surgeon proceed with surgery when grossly positive node s are found at cystectomy? To answer this question, we determine the outcom e of patients after radical surgery alone for grossly node positive bladder cancer. Materials and Methods: A total of 84 patients with grossly node positive (N 2-3) bladder cancer found at cystectomy underwent extended pelvic lymph nod e dissection and have been followed for up to 10 years. The end point of st udy was disease specific survival. Results: Of the 84 patients 20 (24%) survived and 64 (76%) died of disease. Median survival time was 19 months for all patients and 10 years for survi ving patients. Of 53 patients with clinical stage T2 (organ confined) tumor s 17 (32%) survived versus 3 of 31 (9.7%) with stage T3 (extravesical) tumo rs. Conclusions: A proportion of patients with grossly node positive bladder ca ncer can be cured with radical cystectomy and thorough pelvic lymph node di ssection.