During cancer surgery, lymph nodes near the tumor site are traditionally removed and analyzed to see if they contain cancer cells. The results of this analysis are used to plan subsequent therapy; patients who have lymph nodes containing cancer may receive more aggressive treatment than those with no cancer-containing lymph nodes.
In patients with bladder cancer, it has been assumed that those who have more pelvic lymph nodes removed have better survival after bladder removal surgery (cystectomy) than patients with fewer nodes removed, but this has not been examined in a formal clinical trial. The purpose of this phase III clinical trial is to compare patient outcomes after standard versus extended pelvic lymph node removal during cystectomy for bladder cancer.
Patients will be randomly assigned to have standard pelvic node removal or extended node removal, and researchers will follow them over six years to compare the outcomes of both groups. They will also compare the incidence of postoperative complications (such as lymphedema, swelling that can occur after lymph node removal) between the two groups.