Document Detail

Template-based lymphadenectomy in urothelial carcinoma of the upper urinary tract: impact on patient survival.
MedLine Citation:
PMID:  20812922     Owner:  NLM     Status:  MEDLINE    
OBJECTIVES: The benefit of lymphadenectomy (LND) in patients with urothelial carcinoma of the upper urinary tract (UCUUT) has remained controversial. The aim of this study was to examine the influence of the LND template and the total number of lymph nodes (LN) when increasing the number of patients undergoing complete dissection of regional nodes (CompLND).
METHODS: A total of 109 UCUUT patients with clinically negative nodes underwent nephroureterectomy with concomitant lymphadenectomy at our center. Patients' survival was examined according to the type of LND and the number of removed LN. Univariate analysis was performed to find the cut-off value of LN influencing survival.
RESULTS: Seventy-eight patients underwent CompLND. Incomplete lymphadenectomy was performed in an additional 41 patients. In the patients with pT2 or higher who were clinically negative for nodal metastasis, any cut-off value for the total number of LN removed showed no statistical significance. In contrast, CompLND had a significant impact on patient survival. The Cox proportional hazard model showed that CompLND was a significant factor after adjusting for adjuvant chemotherapy. The total number of removed LN was not significant.
CONCLUSIONS: In patients with muscle-invasive clinical node-negative UCUUT, the number of LN removed shows minimal influence on their survival. In contrast, the influence of the particular type of lymphadenectomy is statistically significant. These findings suggest that the extent of lymphadenectomy should be determined by the template and not by the number of removed LN.
Tsunenori Kondo; Yasunobu Hashimoto; Hirohito Kobayashi; Junpei Iizuka; Hayakazu Nakazawa; Fumio Ito; Kazunari Tanabe
Publication Detail:
Type:  Journal Article     Date:  2010-08-31
Journal Detail:
Title:  International journal of urology : official journal of the Japanese Urological Association     Volume:  17     ISSN:  1442-2042     ISO Abbreviation:  Int. J. Urol.     Publication Date:  2010 Oct 
Date Detail:
Created Date:  2010-10-04     Completed Date:  2010-12-22     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9440237     Medline TA:  Int J Urol     Country:  Australia    
Other Details:
Languages:  eng     Pagination:  848-54     Citation Subset:  IM    
Copyright Information:
© 2010 The Japanese Urological Association.
Department of Urology, Tokyo Women's Medical University, Medical Center East, Shinjuku-ku, Tokyo, Japan.
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MeSH Terms
Aged, 80 and over
Kaplan-Meier Estimate
Kidney Neoplasms / mortality*,  pathology,  surgery*
Lymph Node Excision / methods*,  mortality*
Lymphatic Metastasis
Middle Aged
Neoplasm Staging
Survival Analysis
Ureteral Neoplasms / mortality*,  pathology,  surgery*

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