Clinical Significance of Lymph Node Dissection in Patients with Muscle-Invasive Upper Urinary Tract Transitional Cell Carcinoma Treated with Nephroureterectomy.
10.3346/jkms.2009.24.4.674
- Author:
Kang Su CHO
1
;
Hyun Min CHOI
;
Kyochul KOO
;
Sung Jin PARK
;
Koon Ho RHA
;
Young Deuk CHOI
;
Byung Ha CHUNG
;
Nam Hoon CHO
;
Seung Choul YANG
;
Sung Joon HONG
Author Information
1. Department of Urology, the Urological Science Institute, Yonsei University College of Medicine, Seoul, Korea. sjhong346@yuhs.ac
- Publication Type:Original Article
- Keywords:
Carcinoma, Transitional Cell;
Ureter;
Kidney Pelvis;
Recurrence;
Lymph Node Excision
- MeSH:
Aged;
Aged, 80 and over;
Carcinoma, Transitional Cell/mortality/*surgery/therapy;
Female;
Humans;
Kidney Neoplasms/mortality/*surgery/therapy;
*Lymph Node Excision;
Male;
Middle Aged;
Neoplasm Staging;
Nephrectomy;
Recurrence;
Retrospective Studies;
Survival Analysis;
Ureteral Neoplasms/mortality/*surgery/therapy
- From:Journal of Korean Medical Science
2009;24(4):674-678
- CountryRepublic of Korea
- Language:English
-
Abstract:
We investigated the value of lymph node dissection in patients with cN0 muscle-invasive transitional cell carcinoma of the upper urinary tract (UUT-TCC). Medical records of 152 patients with cN0 muscle-invasive UUT-TCC, who underwent nephroureterectomy between 1986 and 2005, were reviewed. Sixty-three patients (41.4%) underwent lymph node dissection. The median number of lymph nodes harvested was 6 (range, 1 to 35), and from these, lymph node involvement was confirmed in 9 patients (14.3%). Locoregional recurrence (LR) and disease-recurrence (DR) occurred in 29 patients and 63 patients, respectively. Fifty-five patients (36.2%) had died of cancer at the last follow-up. The number of lymph nodes harvested was associated with the reduction of LR (chi-square(trend)=6.755, P=0.009), but was not associated with DR (chi-square(trend)=1.558, P=0.212). In the survival analysis, N stage (P=0.0251) and lymph node dissection (P=0.0073) had significant influence on LR, but not on DR or disease-specific survival. However, the number of lymph nodes harvested did not affect LR-free, DR-free, or disease-specific survival. We conclude that lymph node dissection may improve the control of locoregional cancer, as well as staging accuracy, in cN0 muscle-invasive UUT-TCC, but that it does not clearly influence survival.
