Regional lymph node metastasis in renal cell carcinoma: incidence, distribution and its relation to other pathological findings.

Extended ipsilateral lymphadenectomy performed on 102 patients with renal cell carcinoma revealed 21 patients (21%) having regional lymph node metastasis. Of the 21 patients, 6 (6%) had single-node metastasis and 15 (15%) multiple-node metastasis. PT, pV, pM, cell type and grade were all correlated with regional node metastasis. The metastatic lymph node foci were distributed along the pathways of normal lymphatic drainage. The recurrence of the disease was correlated with lymph node metastasis, indicating that metastasis is one of the prognostic factors. The very close correlation of node metastasis with vein invasion suggests that removal at least of the ipsilateral lymph node might be necessary when removal of a thrombus in the renal vein or vena cava is indicated.