S1011 Standard or Extended Pelvic Lymphadenectomy in Treating Patients Undergoing Surgery for Invasive Bladder Cancer

DISEASE CHARACTERISTICS:

Histologically confirmed urothelial carcinoma of the bladder

Stage T2, T3, or T4a disease

No clinical stage consistent with a low-risk of node metastasis (CIS only, T1)
No T4b disease (fixed lesion)

Disease that requires primary radical cystectomy and lymph node dissection for definitive treatment

No laparoscopic surgery

Predominant urothelial carcinoma with any of the following elements allowed:

Adenocarcinoma
Squamous cell carcinoma
Micropapillary or minor components of other rare phenotype
No pure squamous cell carcinoma or adenocarcinoma
No visceral or nodal metastatic disease proximal to the common iliac bifurcation by 2-view chest x-ray and abdominal-pelvic imaging by computerized tomography or MRI of the abdomen and pelvis
No intra-operative pelvic lymph node involvement (confirmed by frozen section) at or above the bifurcation of the common iliac vessels in any of the extended template

PATIENT CHARACTERISTICS:

Zubrod performance status 0-2
ALT and AST ≤ upper limit of normal (ULN)*
Alkaline phosphatase ≤ ULN*
Not pregnant or nursing
Fertile patients must use an effective contraception
No other prior malignancy except adequately treated basal cell or squamous cell skin cancer, in situ cervical cancer, or stage I or II cancer from which the patient is in complete remission for the past 5 years
Medically suitable to undergo cystectomy, in the physician's opinion NOTE: *Levels may be ≥ ULN provided metastatic disease is excluded using dedicated liver imaging, bone scan, or biopsy.

PRIOR CONCURRENT THERAPY:

See Disease Characteristics
No prior partial cystectomy for invasive bladder cancer
No prior pelvic surgery that would obviate a complete extended lymphadenectomy (e.g., aorto-femoral/iliac bypass)
Prior neoadjuvant chemotherapy for this cancer allowed provided it has been completed and patient has recovered
No prior pelvic irradiation