Introduction

1. No. 114 The adoption of routine pelvic lymphadenectomy may be contributing to improved survival outcomes in patients undergoing radical cystectomy for bladder cancer PrassannahSATASIVAM , Gausihi SIVARAJAH, Jeremy GOAD, Janelle BRENNAN St Vincent’s Hospital, Melbourne, Australia • Results • There were a total of 123 male and 37 female patients with a mean age of 69 years. • LNs were sampled in 81 of these 160 patients. • Final pathology was pT2 in 32%, pT3 in 41% and pT4 in 10% of cases. • A median of 0 LNs were retrieved in the 123 cases performed prior to 2006.From 2006 onward, the median number of LNs retrieved increased rapidly from to 2 in 2006 to 18 in 2012 (p < 0.001). • Three-year OS was associated with pN-stage (p = 0.015), pT-stage (p = 0.003) and the presence of lymphatic (p = 0.05) and vascular invasion (p = 0.008). • Introduction • Bilateral pelvic lymphadenectomy (PLND) has been shown to provide a survival benefit for patients undergoing surgery for invasive bladder cancer. • PLND became routine practice at our institution from 2006 onwards. • Aim • The purpose of this study was to determine whether the adoption of routine PLND has resulted in improved survival outcomes for patients undergoing radical cystectomy. • Methods • 160 patients undergoing cystectomy for bladder cancer at St Vincent’s Hospital, Melbourne, were identified retrospectively from Jan 1989 to Aug 2012. • Data was collected with regard to age, gender, pathological features, number of lymph nodes (LNs) removed and number of LNs that were positive for malignancy. • 149 patients had 1-year overall survival (OS) data and 137 patients had 3-year OS data available. • Statistical significance was ascribed to p < 0.05 on Pearson’s Chi-square tests and regression analysis. • Of the 149 patients with 1-year OS data, 97% of patients undergoing cystectomy after 2006 were alive at 1 year, compared to only 72% of patients who had surgery prior to the adoption of routine PLND (p = 0.003). • Conclusions • Given ongoing medical advances and improvements in life expectancy, we should be careful not to attribute the recent improvement in 1-year survival post cystectomy solely to the adoption of PLND. • However, the finding of improved 3-year OS in patients with lymph node sampling is in keeping with the international literature on the benefits of PLND. • The inclusion of an adequate PLND should continue to be considered as the standard of care for patients undergoing cystectomy for bladder cancer. • In keeping with this finding, of the 137 patients with 3-year OS data, 56% who had any number of LNs excised were alive at 3 years compared to only 37% of patients who did not have PLND performed (p = 0.024). References Stenzl et al. Treatment of muscle-invasive and metastatic bladder cancer: update of the EAU guidelines. EurUrol. 2011 Jun;59(6):1009-18. doi: 10.1016/j.eururo.2011.03.023. Epub 2011 Mar 23.