Lymph node assessment and lymphadenectomy in bladder cancer

Lymph node status is a key prognostic indicator in patients with bladder cancer, so lymphadenectomy is important for accurate staging. Moreover, lymphadenectomy is curative for some patients with nodal metastases. Although there is evidence that the quality of regional node dissection is associated with oncologic outcome, controversy exists because other factors may also explain this observation. Consequently, there is no consensus regarding the optimal extent of lymphadenectomy and number of nodes that should be assessed.