Young age increases the risk of lymph-node metastasis in patients with muscle-invasive bladder urothelial carcinoma
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RESEARCH ARTICLE
Open Access
Young age increases the risk of lymphnode metastasis in patients with muscleinvasive bladder urothelial carcinoma Zijian Tian1,2†, Lingfeng Meng1,2†, Xin Wang1, Tongxiang Diao1, Maolin Hu1, Miao Wang1, Ming Liu1* Jianye Wang1,2*
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Abstract Background: The risk of positive lymph nodes in patients with muscle-invasive bladder urothelial carcinoma (MIBC) can be used to guide treatment recommendations. However, little is known about the effect of age on lymph node positivity (LN+). This study aimed to evaluate the effect of age on LN+ in MIBC. Methods: We analyzed patients with stage T2–T4 bladder urothelial carcinoma who had not received preoperative radiotherapy, had at least one lymph node examined, and underwent cystectomy between 1998 and 2015. The Cochran–Armitage trend test and logistic univariate and multivariate analyses were used to evaluate the effect of age on LN+ in all T stages. Results: In total, 15,624 patients with MIBC were identified, including 747 patients aged ≤50 years (4.78%), 2614 patients aged 50–59 years (16.73%), 4914 patients aged 60–69 years (31.45%), 5225 patients aged 70–79 years old (33.44%), and 2124 patients aged > 80 years (13.59%). In T2–T4 staging, LN+ was negatively correlated with age. After adjustment for several covariates, multivariate logistic regression analysis revealed that age was an independent risk factor for LN+. Conclusions: In this large SEER analysis, Young patients with MIBC have a higher risk of lymph node metastasis. This finding is worthy of further study and may eventually affect the treatment decisions of young patients. Keywords: Urinary bladder neoplasms, Lymph nodes, Age at diagnosis
Background Bladder cancer is the most common malignant tumor of the urinary system, with high morbidity and mortality. It is estimated that there will be approximately 81,400 new bladder cancer patients and 17,980 deaths due to this disease in the USA in 2020 [1]. Urothelial carcinoma accounts for approximately 90% of bladder cancers, 25% of which can develop into muscle-invasive bladder cancer * Correspondence: [email protected]; [email protected] † Zijian Tian and Lingfeng Meng contributed equally to this work. 1 Department of Urology, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing 100730, China Full list of author information is available at the end of the article
[2] and approximately half of which are potentially fatal [3]. Radical cystectomy plus pelvic lymph node dissection (PLND) is considered the gold standard treatment for bladder urothelial carcinoma with invasion of the detrusor muscle [4], and up to 25% of patients turn out to have lymph node metastasis during radical cystectomy [5]. Lymph node positivity (LN+) has been shown to be an independent predictor of disease recurrence and cancer-specific death in urothelial carcinoma of the bladder [6]. In patients with muscle-invasive bladder urothelial carcinoma (MIBC), the evaluation of LN+ is very im
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