الفهرس | Only 14 pages are availabe for public view |
Abstract Background: Precise staging of LN status is an important clinico-pathological prognostic parameter following radical cystectomy. Aim of The Work: to assess tumor recurrence in patients with T2 Transitional cell carcinoma undergoing radical cystectomy with extended pelvic lymphadenectomy. Patients and Methods: 80 patients underwent bilateral extended lymphadenectomy during radical cystectomy that reached up to the aortic bifurcation and sentinal lymph node. It was a multi-center study between urology departments of Ain Shams University hospital, Theodor Bilharz research institute and Saint Louis University hospital. Comparison based on classifying patients in 2 groups: -Cytokeratin7&20 positive and negative. Results: In our study we used both cytokeratin 7 and cytokeratin 20 for evaluating the metastatic and micro metastatic burdens in lymph nodes and these markers were correlated with the primary bladder and its nodal metastases. After displaying the results we evaluated the markers as the following: Cytokeratin 7 sensitivity is 100% while specificity 65% and showed 48.8% positive predictive value (PPV) and 100% Negative predictive value (NPV) with overall accuracy 73.8%. Cytokeratin 20 sensitivity is 100% while specificity 65% and showed 48.8% positive predictive value (PPV) and 100% Negative predictive value (NPV) with overall accuracy 73.8%. Conclusion: The use of molecular markers provides a better and proper nodal staging but what is thought to be a disadvantage is the exaggerated sensitivity sometimes gives false positive results. |