BACKGROUND: The utility of lymph node dissection (LND) during radical nephrectomy for renal cell carcinoma (RCC) continues to be controversial, yet its use by urologists in the United States is unknown. We analyzed the incidence of and trends in LND from a large, nationally representative cancer registry. METHODS: Using the Surveillance, Epidemiology, and End Results registry we identified 37,279 patients with RCC who underwent radical nephrectomy from 1988 to 2005. LND was defined as a surgeon removing ≥5 nodes; however, sensitivity tests were performed using cutoffs of ≥3 and ≥1 nodes. We analyzed changes in LND rates over time and used multivariable logistic regression to predict those who underwent LND. RESULTS: Of the 37,279 patients with RCC, 2,463 (6.6 %) received a LND. There was a gradual decline in LND beginning in 1988 that accelerated after 1997, with the period of 1998-2005 having significantly decreased odds of LND compared with the period 1988-1997 (odds ratio [OR]: 0.65; 95 % confidence interval [95 % CI]: 0.59-0.71). This decline was driven primarily by a 63 % reduction in LND rates among localized tumors (p < .001). CONCLUSIONS: There has been a significant decline in LND rates during radical nephrectomy for localized kidney cancer over the past 7 years. In contrast to prior estimates, very few urologists in the United States are removing ≥5 nodes during lymph node dissection for RCC.
BACKGROUND: The utility of lymph node dissection (LND) during radical nephrectomy for renal cell carcinoma (RCC) continues to be controversial, yet its use by urologists in the United States is unknown. We analyzed the incidence of and trends in LND from a large, nationally representative cancer registry. METHODS: Using the Surveillance, Epidemiology, and End Results registry we identified 37,279 patients with RCC who underwent radical nephrectomy from 1988 to 2005. LND was defined as a surgeon removing ≥5 nodes; however, sensitivity tests were performed using cutoffs of ≥3 and ≥1 nodes. We analyzed changes in LND rates over time and used multivariable logistic regression to predict those who underwent LND. RESULTS: Of the 37,279 patients with RCC, 2,463 (6.6 %) received a LND. There was a gradual decline in LND beginning in 1988 that accelerated after 1997, with the period of 1998-2005 having significantly decreased odds of LND compared with the period 1988-1997 (odds ratio [OR]: 0.65; 95 % confidence interval [95 % CI]: 0.59-0.71). This decline was driven primarily by a 63 % reduction in LND rates among localized tumors (p < .001). CONCLUSIONS: There has been a significant decline in LND rates during radical nephrectomy for localized kidney cancer over the past 7 years. In contrast to prior estimates, very few urologists in the United States are removing ≥5 nodes during lymph node dissection for RCC.
Authors: Alessandro Nini; Alessandro Larcher; Walter Cazzaniga; Paolo Dell'Oglio; Francesco Cianflone; Fabio Muttin; Francesco Ripa; Andrea Salonia; Alberto Briganti; Francesco Montorsi; Roberto Bertini; Umberto Capitanio Journal: World J Urol Date: 2018-11-24 Impact factor: 4.226
Authors: Marco Bandini; Ariane Smith; Emanuele Zaffuto; Raisa S Pompe; Michele Marchioni; Umberto Capitanio; Felix K Chun; Anil B Kapoor; Shahrokh F Shariat; Francesco Montorsi; Alberto Briganti; Pierre I Karakiewicz Journal: World J Urol Date: 2017-10-11 Impact factor: 4.226
Authors: Alain Kaldany; Zev R Leopold; Juliana E Kim; Hiren V Patel; Arnav Srivastava; Alexandra L Tabakin; Eric A Singer Journal: Kidney Cancer J Date: 2020-12
Authors: Hye Won Lee; Hwang Gyun Jeon; Byong Chang Jeong; Seong Il Seo; Seong Soo Jeon; Han Yong Choi; Hyun Moo Lee Journal: J Korean Med Sci Date: 2015-08-13 Impact factor: 2.153