To investigate the effect of mean pelvic lymph node diameter on tumor recurrence in patients with muscle-invasive bladder cancer without lymph node metastasis.

The clinicopathological data of 71 patients with bladder cancer treated in 909th Hospital of the Chinese People's Liberation Army Joint Logistic Support Force from 2012 to 2016 were retrospectively analyzed.According to the follow-up results, tumor recurrence occurred in 27 cases. The ROC author curve was used to analyze the optimal threshold for predicting tumor recurrence.The relationship between the mean diameter of pelvic lymph nodes and clinicopathology were analyzed.Univariate and Cox multivariate analysis of tumor recurrence factors.

The area under ROC curve (AUC) was 0.749, the optimal limit of average lymph node diameter was 0.675 cm, 95%CI was 0.632-0.865, sensitivity was 0.852, and specificity was 0.648. The mean diameter of lymph nodes increased in patients with tumor stage T3, poorly differentiated tumor, positive vascular invasion and tumor recurrence (t=-2.021, -2.131, -2.569, -3.945, P<0.05). Univariate analysis showed that patients with tumor stage T3, low tumor differentiation, positive vascular invasion and mean lymph node diameter >0.675 cm had a higher recurrence rate (χ²=23.608, 3.968, 12.776, 8.925, P<0.05). Multivariate analysis showed that T3 and mean lymph node diameter >0.675 cm were independent risk factors for tumor recurrence (95%CI= 1.627-9.562, 0.163-2.050, P<0.05).

Pelvic lymph node diameter is associated with tumor stage, differentiation and vascular invasion in patients with muscle-invasive bladder cancer without lymph node metastasis, which is an independent risk factor for tumor recurrence and may have certain clinical significance in determining prognosis and formulating individualized treatment plan.