Analysis of lymph node dissection in patients with ?-cm renal tumors
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- 作者：Michael A. Feuerstein (1)
Matthew Kent (2)
Wassim M. Bazzi (1)
Melanie Bernstein (1)
Paul Russo (1) - 关键词：Carcinoma ; renal cell ; Nephrectomy ; Lymph node dissection
- 刊名：World Journal of Urology
- 出版年：2014
- 出版时间：December 2014
- 年：2014
- 卷：32
- 期：6
- 页码：1531-1536
- 全文大小：278 KB
- 参考文献：1. Kim SP, Crispen PL, Thompson RH et al (2012) Assessment of the pathologic inclusion criteria from contemporary adjuvant clinical trials for predicting disease progression after nephrectomy for renal cell carcinoma. Cancer 15(118):4412-420 CrossRef
2. Stephenson AJ, Chetner MP, Rourke K et al (2004) Guidelines for the surveillance of localized renal cell carcinoma based on the patterns of relapse after nephrectomy. J Urol 172:58-2 CrossRef
3. Capitanio U, Becker F, Blute ML et al (2011) Lymph node dissection in renal cell carcinoma. Eur Urol 60:1212-220 CrossRef
4. Zisman A, Pantuck AJ, Wieder J et al (2002) Risk group assessment and clinical outcome algorithm to predict the natural history of patients with surgically resected renal cell carcinoma. J Clin Oncol 1(20):4559-566 CrossRef
5. Robson CJ (1963) Radical nephrectomy for renal cell carcinoma. J Urol 89:37-2
6. Godoy G, O’Malley RL, Taneja SS (2008) Lymph node dissection during the surgical treatment of renal cancer in the modern era. Int Braz J Urol 34:132-42 CrossRef
7. Herr HW, Donat SM (2001) Outcome of patients with grossly node positive bladder cancer after pelvic lymph node dissection and radical cystectomy. J Urol 165:62-4 CrossRef
8. Palapattu GS, Allaf ME, Trock BJ, Epstein JI, Walsh PC (2004) Prostate specific antigen progression in men with lymph node metastases following radical prostatectomy: results of long-term followup. J Urol 172:1860-864 CrossRef
9. Srinivas V, Morse MJ, Herr HW, Sogani PC, Whitmore WF Jr (1987) Penile cancer: relation of extent of nodal metastasis to survival. J Urol 137:880-82
10. Karakiewicz PI, Trinh QD, Bhojani N et al (2007) Renal cell carcinoma with nodal metastases in the absence of distant metastatic disease: prognostic indicators of disease-specific survival. Eur Urol 51:1616-624 CrossRef
11. Delacroix SE Jr, Chapin BF, Chen JJ et al (2011) Can a durable disease-free survival be achieved with surgical resection in patients with pathological node positive renal cell carcinoma? J Urol 186:1236-241 CrossRef
12. Pantuck AJ, Zisman A, Dorey F et al (2003) Renal cell carcinoma with retroperitoneal lymph nodes: role of lymph node dissection. J Urol 169:2076-083 CrossRef
13. Schafhauser W, Ebert A, Brod J, Petsch S, Schrott KM (1999) Lymph node involvement in renal cell carcinoma and survival chance by systematic lymphadenectomy. Anticancer Res 19:1573-578
14. Herrlinger A, Schrott KM, Schott G, Sigel A (1991) What are the benefits of extended dissection of the regional renal lymph nodes in the therapy of renal cell carcinoma. J Urol 146:1224-227
15. Blom JH, van Poppel H, Marechal JM et al (2009) Radical nephrectomy with and without lymph-node dissection: final results of European organization for research and treatment of cancer (EORTC) randomized phase three trial 30881. Eur Urol 55:28-4 CrossRef
16. Studer UE, Birkhauser FD (2009) Lymphadenectomy combined with radical nephrectomy: to do or not to do? Eur Urol 55:35-7 CrossRef
17. Karam JA, Wood CG (2011) The role of surgery in advanced renal cell carcinoma: cytoreductive nephrectomy and metastasectomy. Hematol Oncol Clin North Am 25:753-64 CrossRef
18. Montgomery JS, Leibovich BC (2013) Lymph node excision for renal cancer. J Urol 189:419-21- 作者单位：Michael A. Feuerstein (1)
Matthew Kent (2)
Wassim M. Bazzi (1)
Melanie Bernstein (1)
Paul Russo (1)
1. Urology Service, Department of Surgery, Memorial Sloan-Kettering Cancer Center, 1275 York Avenue, New York, NY, 10065, USA
2. Department of Epidemiology and Biostatistics, Memorial Sloan-Kettering Cancer Center, New York, NY, USA- ISSN：1433-8726
- 作者单位：Michael A. Feuerstein (1)
文摘
Purpose To analyze the role of lymph node dissection (LND) in patients with large renal tumors. Methods We performed a retrospective study of patients with renal cell carcinoma ??cm in size undergoing surgery between 1990 and 2012. Primary outcome measures were recurrence-free and overall survival of patients who did and did not undergo LND. Cox proportional hazards regression models were created to account for known risk factors for recurrence and survival. Secondary outcomes were recurrence-free and overall survival by lymph node status, lymph node template and number of lymph nodes removed. Results Of 524 patients, 164 had disease recurrence and 197 died. Median follow-up was 5 and 5.5?years for patients who did not die or have a recurrence, respectively. A total of 334 (64?%) patients underwent LND, and node-positive disease was identified in 26 (8?%). For patients who did and did not undergo LND, 5-year recurrence-free survival was 64 and 77?%, respectively. Five-year overall survival was 75 and 78?%, respectively. LND was not a predictor of recurrence or survival in multivariate analysis. Node-positive disease was associated with recurrence (p?p?=?0.032), although node-positive patients had a 5-year overall survival of 65?%. Conclusions We did not find a difference in recurrence-free or overall survival in patients with ?-cm tumors whether or not they underwent LND. Node-positive disease was associated with worse outcomes, suggesting that LND provides important staging information that can be important in the design of adjuvant clinical trials.