Extended Versus Non-Extended Lymphadenectomy in Radical Cystectomy for Bladder Cancer: A Systematic Review and Meta-Analysis.
Maria Fernanda Dias Azevedo, Pedro Henrique Souza Brito, Lucas Kallas-Silva et al.
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In 30 seconds
This systematic review and meta-analysis evaluated the outcomes of extended versus non-extended lymphadenectomy during radical cystectomy for bladder cancer in 5671 patients across 15 studies. The analysis found that extended lymphadenectomy increased operative time by 26.2 minutes and improved disease-free survival (DFS) with a hazard ratio of 1.47, but did not show significant benefits in overall or cancer-specific survival.
Key findings
- Extended lymphadenectomy increased operative time by 26.2 minutes.
- Extended lymphadenectomy improved disease-free survival with a hazard ratio of 1.47.
- Non-extended lymphadenectomy was associated with higher recurrence-free survival (HR: 0.79).
- Certainty of evidence was very low for most outcomes.
Why it matters
Understanding the implications of lymphadenectomy extent during radical cystectomy is crucial for optimizing surgical strategies and patient outcomes in bladder cancer management. The findings highlight the need for careful consideration of operative time versus potential survival benefits.
What to keep in mind
Heterogeneity was moderate to high, and the certainty of evidence was very low for most outcomes.