Objective. To determine the outcome in patients with nodal metastases from transitional cell carcinoma (TCC) using currently available surgical and chemotherapeutic techniques. Methods. A retrospective analysis of all patients with TCC of the lower urinary tract who underwent radical cystectomy or lymph node dissection at our institution since 1980 was performed. Thirty-one patients were identified who had documented pelvic lymph node metastases prior to or at the time of radical cystectomy. These patients' records were reviewed in-depth with regard to treatment approach, presenting features, and outcome. Results. Outcome was poor despite the treatment approach taken, including whether or not chemotherapy was administered prior to or after cystectomy. Median survivals of patients receiving no chemotherapy, adjuvant chemotherapy, and neoadjuvant chemotherapy were 14.5, 9.5, and 15.0 months, respectively. Only 4 of 28 patients survived more than three years, and only one of these received chemotherapy. Conclusions. Survival of patients with lymph node metastases from transitional cell carcinoma remains poor despite aggressive surgical therapy and the use of adjuvant or neoadjuvant platinum-based chemotherapy.
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