Standardization of radical cystectomy and pelvic lymph node dissection for bladder cancer: A collaborative group report

Purpose: We propose standards for radical cystectomy and pelvic lymph node dissection in the surgical treatment of patients with invasive bladder cancer. Materials and Methods: We compiled the consecutive cystectomy experience of 16 experienced surgeons during the last 3 years (2000 to 2002) from 4 institutions. We evaluated patient, tumor and surgical variables of margin status, extent of pelvic node dissection, number of nodes examined and surgeon volume associated with bladder cancer outcomes. Results: A total of 1,091 cystectomy cases were evaluated. Surgical margins and number of nodes retrieved correlated with patient age, prior treatments, pathological tumor stage and extent of node dissection, but not surgeon volume. Conclusions: Standards for radical cystectomy can be established and achieved by experienced surgeons operating on patients presenting with diverse clinical situations.