The role of lymph-node dissection in the treatment of upper urinary tract cancer: a multi-institutional study.
BJU Int
; 102(5): 576-80, 2008 Aug 05.
Article
em En
| MEDLINE
| ID: mdl-18410428
ABSTRACT
OBJECTIVES:
To determine the role of lymph-node (LN) dissection in patients undergoing surgery for upper urinary tract (UUT) cancer. PATIENTS ANDMETHODS:
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.RESULTS:
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.CONCLUSIONS:
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.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Neoplasias Urológicas
/
Excisão de Linfonodo
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Linfonodos
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Nefrectomia
Tipo de estudo:
Observational_studies
/
Prognostic_studies
Limite:
Adult
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Aged
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Aged80
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Female
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Humans
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Male
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Middle aged
Idioma:
En
Revista:
BJU Int
Ano de publicação:
2008
Tipo de documento:
Article