الفهرس 
Introduction and aim of the work
Treatment of invasive bladder tumourOnly 14 pages are availabe for public view
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Abstract
Radical cystectomy and pelvic lymphadenectomy is the standard ablative surgical procedure for invasive bladder cancer. The role of the lymphadenectomy is still controversial. A little information is available regarding the required limit of lymphadenectomy in invasive bladder tumour. Aim of the work: A prospective study was performed between June 1997 and December 1999 in Urology and nephrology center, Mansoura University to evaluate the incidence and distribution in addition to the pattern of nodal metastases in invasive bladder tumour and to define the therapeutic impact of the extent of the lymphadenectomy. Material and Methods: 418 patient were enrolled in this study with mean age of 52.7 years. The limit of lymphadenectomy extended from the biforcation of aorta downward. Six groups pf lymph nodes were removed. Results; The incidence of nodal involvement wa 26.3%. Single nodal involvement was encountered in 40% of cases with nodal metastases. The endopelvic group of lymph nodes was the most common affected group (70%). Among 7499 removed nodes, only 451 were positive (6%). The overall disease free survival was 67.9% after 3 years. The most important predictor of survival was the stage of the primary tumour and nodal involvement and number of positive nodes. We did not found any significance to the total number of removed nodes on the patient survival. In conclusion: Lymphadenectomy with radical cystectomy should include the common iliac lymph nodes and should be bilateral regardless the tumour location.