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Does 'extended' pelvic lymphadenectomy truly contribute to the management of bladder carcinoma?

During a 3-year period, 41 patients with primary bladder carcinoma were treated with cystectomy along with pelvic lymphadenectomy. Although lymphadenectomy was useful for more accurate staging in patients with T2 or more invasive disease, it contributed little to the surgical curability of the disease, irrespective of extensive nodal dissection in the pelvis. Based on the characteristic lymphatic spread of the disease, limited dissection to the regional nodal area seemed to be satisfactory in the surgical management of bladder carcinoma.