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