The role of lymph-node dissection in the treatment of upper urinary tract cancer: a multi-institutional study

BJU International
Takashige AbeKatsuya Nonomura

Abstract

To determine the role of lymph-node (LN) dissection in patients undergoing surgery for upper urinary tract (UUT) cancer. We reviewed the clinicopathological data from 312 patients with UUT cancer treated predominantly by nephroureterectomy. The relationship between clinical characteristics and cancer-specific survival (CSS) was analysed, focusing on node-related information. In all, 166 patients had LN dissection while 146 did not (pNx). Multivariate analysis showed that T stage, grade and pN status were significant variables for CSS. The difference in survival between the pN0 and pNx groups remained significant in a multivariate analysis. The median (range) number of LNs removed was 6 (1-65). There was no significant difference in CSS between the 72 patients with fewer than six LNs removed and the 78 with six or more removed. LN dissection is important for postoperative stratification of patients with UUT cancer because node-positive disease was one of the variables with a significant adverse effect on survival. In addition, the significant difference in survival between the pN0 and pNx groups might indicate a therapeutic benefit of LN dissection, although removing more LNs did not uniformly increase the probability of CSS.

References

Oct 6, 2005·European Urology·Fredrik Liedberg, Wiking Månsson

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Citations

Feb 7, 2016·Urology·Rao S Mandalapu, Surena F Matin
Nov 3, 2011·The Urologic Clinics of North America·Christopher J Weight, Mathew T Gettman
Jul 30, 2011·European Urology·Marco RoscignoRichard Zigeuner
Sep 14, 2010·European Journal of Surgical Oncology : the Journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology·T AbeK Nonomura
Sep 4, 2010·International Journal of Urology : Official Journal of the Japanese Urological Association·Tsunenori KondoKazunari Tanabe
Jul 8, 2016·AJR. American Journal of Roentgenology·Yun MaoMukesh Harisinghani
May 25, 2011·Nature Reviews. Urology·Jamie MesserJay D Raman

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