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Bladder Urothelial Carcinoma: Is Age Related to Risk of Lymph Node Metastasis?

By: Hope Craig, MSPH
Posted: Friday, October 30, 2020

Young patients with muscle-invasive bladder urothelial carcinoma may have a higher risk of lymph node metastasis than older patients, according to findings of an article published in BMC Cancer. In the large retrospective cohort study, Zijian Tian, PhD, of the Department of Urology, Beijing Hospital, and colleagues showed that lymph node positivity appears to be negatively correlated with age in patients with stage T2–T4 disease.

“Considering the different lymph node invasiveness in patients of different ages, our results can guide clinicians to choose the best treatment. Our findings are worthy of further study and may influence the assessment of lymph node invasiveness in patients with muscle-invasive bladder urothelial carcinoma,” commented the authors.

The authors analyzed the records of 15,624 patients diagnosed with muscle-invasive bladder urothelial carcinoma between 1988 and 2015 in the SEER database. They included only patients clinically or pathologically diagnosed with muscle-invasive bladder urothelial carcinoma who underwent surgery and had at least one lymph node examined. Patients were classified into 10-year age groups. A total of 747 patients (4.8%) were aged 50 or younger, 7,528 patients (48.2%) were between the ages of 50 and 70, and 7,369 patients (47.0%) were older than 70.

Using the Cochran-Armitage trend test, the authors found that younger patients had a higher tendency for lymph node positivity at any T stage. They validated the results in multivariate analyses adjusted for age, sex, race, tumor grade, year of operation, and number of lymph node examinations. The largest difference in association between age and the rate of lymph node positivity was observed in the adjusted analyses at T2 stage; compared with the reference group (80 and older), younger patients (< 50) with T2 and T4 stages of disease were more likely to have lymph node positivity (adjusted odds ratios = 1.805 and 1.239, respectively).

Disclosure: The authors reported no conflicts of interest.

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