Lymph Node Dissection in Bladder Cancer

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The number of lymph nodes removed from individuals with muscle-invasive bladder cancer is being used as a surrogate measure for the quality of the dissection, says Dean F. Bajorin, MD. There are studies looking at defining a dissection up to the bifurcation of the iliacs versus up to the bifurcation of the aorta, and whether greater or extended lymph node dissection makes a difference.

It is important to standardize the way the procedure is performed to maintain consistency from institution to institution. Ongoing clinical trials are assessing how a dissection should be defined, including the definitions of standard dissection and extended dissection.