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 Mar 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, earned his medical degree from the University of California at Los Angeles. Dr. Bocher then completed his urology and surgery residencies at the University of Southern California School of Medicine. He completed a fellowship in urologic oncology at the University of Southern California Norris Comprehensive Cancer Center under the mentorship of Dr. Donald Skinner as an American Foundation for Urologic Disease fellow and recipient of a Clinical Oncology Career Development award from the American Cancer Society. Dr. Bochner is currently a urologic surgeon at Memorial Sloan Kettering Cancer Center (MSKCC) and a Professor of Urology at the Weill Medical College of Cornell University.
Dr. Bochner is the inaugural holder of the Sir Murray Brennan Endowed Chair in Surgery at MSKCC and clinical lead of the urothelial disease management team at Memorial. Dr. Bochner specializes in cancers of the genitourinary system, including bladder, prostate, kidney, and testis. Dr Bochner’s clinical focus is on urologic oncology with a particular interest in urothelial cancer and pelvic reconstructive surgery. He is actively involved in translational research and is the co-PI of a project as part of the MSKCC Bladder Cancer SPORE grant as well as the PI or coPI of several active phase 1-3 clinical trials. Nationally, Dr. Bochner has participated as a member of The Cancer Genome Atlas (TCGA) project in bladder cancer, led the urothelial cancer working group of the Genitourinary Task Force of the American Joint Committee on Cancer (AJCC) for the last two staging revisions, and is a member of the AUA/SUO/ASCO/ASTRO Muscle Invasive Bladder Cancer guideline panel. He is also a fellow in the American Surgical Association (ASA) and current secretary/treasurer of the Society of Pelvic Surgeons (SPS).
