{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T18:58:53Z","timestamp":1790621933329,"version":"4.1.0"},"reference-count":35,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T00:00:00Z","timestamp":1787702400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T00:00:00Z","timestamp":1787702400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Surgical Oncology"],"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>Pelvic lymph node dissection is an essential component of radical cystectomy (RC) for bladder cancer (BC), but the optimal extent of lymphadenectomy remains uncertain. We conducted a systematic review and meta\u2010analysis to compare oncologic and perioperative outcomes between extended and non\u2010extended lymphadenectomy during RC for BC. PubMed\/MEDLINE, Embase, and ClinicalTrials. gov were searched up to October 2025 following PRISMA guidelines and PROSPERO registration. Randomized controlled trials (RCTs) and observational studies comparing extended versus non\u2010extended lymphadenectomy in adults undergoing RC were included. Outcomes included surgery duration, intraoperative blood loss, overall survival (OS), disease\u2010free survival (DFS), recurrence\u2010free survival (RFS), and cancer\u2010specific survival (CSS). Random\u2010effects meta\u2010analyses were performed, reporting hazard ratios (HRs) or mean differences (MDs) with 95% confidence intervals (CIs). Risk of bias was assessed using RoB 2.0 and ROBINS\u2010I, and certainty of evidence using GRADE. Fifteen studies including 5671 patients were analyzed, of which two were RCTs. Extended lymphadenectomy was associated with longer operative time (MD\u2009+\u200926.2\u2009min) and improved DFS (HR: 1.47), but no significant benefit in OS or CSS. Non\u2010extended lymphadenectomy was associated with higher RFS (HR: 0.79). Heterogeneity was moderate to high, and certainty of evidence was very low for most outcomes and low for OS considering only RCTs. Extended lymphadenectomy during RC increases operative time and may improve DFS; however, the available evidence does not clearly support a consistent oncologic benefit.<\/jats:p>","DOI":"10.1002\/jso.70334","type":"journal-article","created":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T06:37:13Z","timestamp":1787812633000},"page":"617-630","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Extended Versus Non\u2010Extended Lymphadenectomy in Radical Cystectomy for Bladder Cancer: A Systematic Review and Meta\u2010Analysis"],"prefix":"10.1002","volume":"134","author":[{"given":"Maria Fernanda Dias","family":"Azevedo","sequence":"first","affiliation":[{"name":"Faculdade Israelita de Ci\u00eancias da Sa\u00fade Albert Einstein S\u00e3o Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pedro Henrique Souza","family":"Brito","sequence":"additional","affiliation":[{"name":"Universidade Cidade de S\u00e3o Paulo S\u00e3o Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lucas","family":"Kallas\u2010Silva","sequence":"additional","affiliation":[{"name":"Universidade Federal de S\u00e3o Paulo\/UNIFESP S\u00e3o Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bruno","family":"Liebl","sequence":"additional","affiliation":[{"name":"Universidade Federal do Paran\u00e1\/UFPR Curitiba Paran\u00e1 Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Beatriz Taveira","family":"Constantinou","sequence":"additional","affiliation":[{"name":"Universidade Nove de Julho, S\u00e3o Bernardo do Campo S\u00e3o Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-1965-6514","authenticated-orcid":false,"given":"Bianca Caroline","family":"Benedicto","sequence":"additional","affiliation":[{"name":"Universidade Nove de Julho, S\u00e3o Bernardo do Campo S\u00e3o Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lucas Paschoalino de","family":"Oliveira","sequence":"additional","affiliation":[{"name":"Universidade Nove de Julho, S\u00e3o Bernardo do Campo S\u00e3o Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mauricio Dener","family":"Cordeiro","sequence":"additional","affiliation":[{"name":"Divis\u00e3o de Urologia, Instituto do C\u00e2ncer do Estado de S\u00e3o Paulo Universidade de S\u00e3o Paulo S\u00e3o Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"William Carlos","family":"Nahas","sequence":"additional","affiliation":[{"name":"Divis\u00e3o de Urologia, Instituto do C\u00e2ncer do Estado de S\u00e3o Paulo Universidade de S\u00e3o Paulo S\u00e3o Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Walid","family":"Shabana","sequence":"additional","affiliation":[{"name":"Department of Urology Thunder Bay Regional Health Sciences Centre and Northern Ontario School of Medicine University Thunder Bay Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Walid","family":"Shahrour","sequence":"additional","affiliation":[{"name":"Department of Urology Thunder Bay Regional Health Sciences Centre and Northern Ontario School of Medicine University Thunder Bay Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leopoldo Alves","family":"Ribeiro\u2010Filho","sequence":"additional","affiliation":[{"name":"Divis\u00e3o de Urologia, Instituto do C\u00e2ncer do Estado de S\u00e3o Paulo Universidade de S\u00e3o Paulo S\u00e3o Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1364-5508","authenticated-orcid":false,"given":"Caio Vinicius","family":"Suartz","sequence":"additional","affiliation":[{"name":"Department of Urology Thunder Bay Regional Health Sciences Centre and Northern Ontario School of Medicine University Thunder Bay Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,8,26]]},"reference":[{"issue":"3","key":"e_1_2_8_2_1","first-page":"209","article-title":"Global Cancer Statistics 2020: GLOBOCAN Estimates of Incidence and Mortality Worldwide for 36 Cancers in 185 Countries","volume":"71","author":"Sung H.","year":"2021","journal-title":"CA: A Cancer Journal for Clinicians"},{"key":"e_1_2_8_3_1","unstructured":"EAU Guidelines on MIBC \u2010 Introduction\u2014Uroweb [Internet]. [cited 2025 Nov 23] https:\/\/uroweb.org\/guidelines\/muscle-invasive-and-metastatic-bladder-cancer."},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1097\/JU.0000000000003981"},{"issue":"2","key":"e_1_2_8_5_1","doi-asserted-by":"crossref","DOI":"10.1016\/j.clgc.2021.10.010","article-title":"Contemporary Trends and Efficacy of Pelvic Lymph Node Dissection at Radical Cystectomy for Urothelial and Variant Histology Carcinoma of the Urinary Bladder","volume":"20","author":"Kosiba M.","year":"2022","journal-title":"Clinical Genitourinary Cancer [Internet]"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.ju.0000102302.26806.fb"},{"issue":"4","key":"e_1_2_8_7_1","doi-asserted-by":"crossref","first-page":"604","DOI":"10.1016\/j.eururo.2018.09.047","article-title":"Extended Versus Limited Lymph Node Dissection in Bladder Cancer Patients Undergoing Radical Cystectomy: Survival Results From a Prospective, Randomized Trial","volume":"75","author":"Gschwend J. 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