PURPOSE: We determined the impact of the extent of regional lymphadenectomy on survival in patients with urothelial carcinoma of the upper urinary tract. MATERIALS AND METHODS: Between January 1989 and January 2006, 169 patients with nonmetastatic urothelial carcinoma of the upper urinary tract underwent curative surgery. We previously reported the primary sites of nodal metastases in urothelial carcinoma of the upper urinary tract. Nodal sites where the incidence of metastases was 30% or more were considered regional lymph nodes. When all primary sites were resected, this was considered complete lymphadenectomy. Regional lymphadenectomy without the removal of all primary sites was considered incomplete lymphadenectomy. We retrospectively analyzed the influence of the extent of lymphadenectomy on patient survival. RESULTS: A total of 45 patients (26.6%) underwent complete lymphadenectomy. Lymphadenectomy was performed in an additional 36 patients (21.3%) but it was incomplete. Lymphadenectomy was not performed in 88 patients. Cancer specific survival did not significantly differ between the groups when all patients were analyzed. However, patient survival significantly depended on the extent of lymphadenectomy when we focused on patients with T stage pT3 or higher. Patient survival was likely to improve when the number of lymph nodes removed increased. Multivariate analysis showed that complete lymphadenectomy was a significant prognostic factor for cancer specific survival (p = 0.009) as well as T stage (pT3 or less p = 0.0004) and tumor grade (G3 p = 0.0001). CONCLUSIONS: Although further investigation is required to make a definite conclusion, the extent of lymphadenectomy may significantly influence its therapeutic effect, especially for patients with advanced disease.
PURPOSE: We determined the impact of the extent of regional lymphadenectomy on survival in patients with urothelial carcinoma of the upper urinary tract. MATERIALS AND METHODS: Between January 1989 and January 2006, 169 patients with nonmetastatic urothelial carcinoma of the upper urinary tract underwent curative surgery. We previously reported the primary sites of nodal metastases in urothelial carcinoma of the upper urinary tract. Nodal sites where the incidence of metastases was 30% or more were considered regional lymph nodes. When all primary sites were resected, this was considered complete lymphadenectomy. Regional lymphadenectomy without the removal of all primary sites was considered incomplete lymphadenectomy. We retrospectively analyzed the influence of the extent of lymphadenectomy on patient survival. RESULTS: A total of 45 patients (26.6%) underwent complete lymphadenectomy. Lymphadenectomy was performed in an additional 36 patients (21.3%) but it was incomplete. Lymphadenectomy was not performed in 88 patients. Cancer specific survival did not significantly differ between the groups when all patients were analyzed. However, patient survival significantly depended on the extent of lymphadenectomy when we focused on patients with T stage pT3 or higher. Patient survival was likely to improve when the number of lymph nodes removed increased. Multivariate analysis showed that complete lymphadenectomy was a significant prognostic factor for cancer specific survival (p = 0.009) as well as T stage (pT3 or less p = 0.0004) and tumor grade (G3 p = 0.0001). CONCLUSIONS: Although further investigation is required to make a definite conclusion, the extent of lymphadenectomy may significantly influence its therapeutic effect, especially for patients with advanced disease.
Authors: Ricardo L Favaretto; Shahrokh F Shariat; Caroline Savage; Guilherme Godoy; Daher C Chade; Matthew Kaag; Bernard H Bochner; Jonathan Coleman; Guido Dalbagni Journal: BJU Int Date: 2011-06-01 Impact factor: 5.588
Authors: Maximilian Burger; Shahrokh F Shariat; Hans-Martin Fritsche; Juan Ignacio Martinez-Salamanca; Kazumasa Matsumoto; Thomas F Chromecki; Vincenzo Ficarra; Wassim Kassouf; Christian Seitz; Armin Pycha; Stefan Tritschler; Thomas J Walton; Giacomo Novara Journal: World J Urol Date: 2011-06-01 Impact factor: 4.226
Authors: Adil Ouzzane; Pierre Colin; Tarek P Ghoneim; Marc Zerbib; Alexandre De La Taille; François Audenet; Fabien Saint; Nicolas Hoarau; Emilie Adam; Marie Dominique Azemar; Henri Bensadoun; Luc Cormier; Olivier Cussenot; Alain Houlgatte; Gilles Karsenty; Charlotte Maurin; François Xavier Nouhaud; Véronique Phe; Thomas Polguer; Mathieu Roumiguié; Alain Ruffion; Morgan Rouprêt Journal: World J Urol Date: 2012-12-11 Impact factor: 4.226
Authors: Kang Su Cho; 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 Journal: J Korean Med Sci Date: 2009-07-29 Impact factor: 2.153