What to do if the lymph nodes are positive

Christopher P Evans, D. A. Swanson

Research output: Contribution to journalArticlepeer-review

7 Scopus citations


Lymph node metastases are common in patients with advanced bladder cancer. Survival rates have apparently improved from about 15% to 30% as management evolved from lymphadenectomy plus cystectomy to multimodal therapy, but investigators have not conclusively shown the benefit of adjuvant irradiation and/or chemotherapy. If clinical staging indicates nodal metastases, we recommend primary multiagent chemotherapy with subsequent exploratory laparotomy, lymphadenectomy, and possibly cystectomy for complete responders. Patients without clinical evidence of metastases undergo complete bilateral pelvic lymphadenectomy plus cystectomy if nodes are normal, or if grossly abnormal but resectable. Patients with nodal metastases may be candidates for adjuvant chemotherapy.

Original languageEnglish (US)
Pages (from-to)96-102
Number of pages7
JournalSeminars in Urologic Oncology
Issue number2
StatePublished - 1996
Externally publishedYes


  • bladder cancer
  • Lymph nodes
  • metastases

ASJC Scopus subject areas

  • Urology


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