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- W2160373571 abstract "proved to be a poor prognostic factor in the delayed cystectomy group (P ¼ .01) but not in the early cystectomy group. We believe that these results confirm that LVI is a feature of biologically and clinically aggressive urothelial bladder cancer and is therefore independently associated with poor clinical outcomes after radical cystectomy. Consequently, several concerns regarding the clinical and surgical approach to high-grade pT1 bladder cancer should be taken into consideration. LVI can be regarded as a surrogate marker for the presence of micrometastases in the lymph nodes at the time of surgical treatment, and this could explain the differences in terms of survival outcomes in patients who undergo early cystectomy and pelvic lymph node dissection when compared with those who are treated with delayed cystectomy and pelvic lymph node dissection. We strongly believe that a higher prevalence of micrometastatic nodal disease could be observed in patients with LVI at the time of TURB, thus justifying the differences in terms of cancer-specific survival and OS in node-negative disease as well. Based on this critical statement as well as several previous clinical studies 2,8,9 and the results of Brancherau et al’s study, 1 should urologists perform a more extended pelvic lymph node dissection in patients with specimens that are positive for LVI and who are scheduled to undergo delayed radical cystectomy after conservative management failure? Should we offer a neoadjuvant treatment for stage pT1 LVIpositive, high-grade bladder cancer? As a criterion of severity, LVI might be used to identify high-risk patients who could benefit from “targeted” medical and surgical procedures." @default.
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- W2160373571 date "2014-04-01" @default.
- W2160373571 modified "2023-09-25" @default.
- W2160373571 title "Lymphovascular Invasion in High Grade T1 Bladder Cancer: Are More Aggressive Treatments Needed?" @default.
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- W2160373571 doi "https://doi.org/10.1016/j.clgc.2013.03.002" @default.
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