Bernard H. Bochner, MD, FACS, presented “Role of PLND for High Risk Bladder Cancer” at the 7th International Bladder Cancer Update on December 6, 2024, in Dallas, Texas.
How to cite: Bochner, Bernard H. “Role of PLND for High Risk Bladder Cancer” December 2024. Accessed Nov 2025. https://grandroundsinurology.com/role-of-plnd-for-high-risk-bladder-cancer/
Role of PLND for High Risk Bladder Cancer – Summary
Bernard H. Bochner, MD, FACS, examines the extent of lymph node dissection in bladder cancer surgery and its impact on oncologic outcomes. In this 14-minute presentation, he addresses pelvic lymph node involvement in invasive bladder cancer; historical data suggest that about one-third of patients with node-positive disease achieve long-term survival following surgery alone.
Dr. Bochner debates whether extending the lymph node dissection above the common iliac bifurcation to the aortic bifurcation improves outcomes. A German trial demonstrated a 5% improvement in recurrence-free survival with extended dissection. However, the SWOG S1011 trial excluded patients with radiographically evident N3 disease and found no benefit. Morbidity rates varied, with the German study showing no increased complications, whereas SWOG reported a significant rise in major surgical toxicities. The findings suggest that extended lymph node dissection may benefit high-risk patients but remains controversial due to study limitations and selection biases.
Dr. Bochner believes that standardization of surgical approaches and further trials are needed to clarify the role of extended lymphadenectomy in bladder cancer management.
About the 7th International Bladder Cancer Update:
The International Bladder Cancer Update (IBCU) is a CME conference focused on the diagnosis and treatment of bladder cancer. The conference offers medical professionals an opportunity to listen to updates from, and interact with, expert international faculty to improve knowledge and determine best treatment practices to improve patient outcomes. IBCU encompasses expert lectures, interactive discussions, a panel roundtable, debates, and case presentations. It is physician-led, multi-supported, and designed for urologists, urologic oncologists, and other healthcare professionals involved in the treatment of bladder cancer.
For further educational activities from this conference, visit our collection page.
ABOUT THE AUTHOR
Bernard H. Bochner, MD, FACS, is the Sir Murray F. Brennan Chair in Surgery and a Professor in the Department of Urology at Memorial Sloan Kettering Cancer Center in New York, New York. Dr. Bochner’s main areas of expertise include radical surgical procedures for invasive bladder cancer and reconstructive surgery of the urinary system following radical cystectomy or pelvic exenteration.
