OBJECTIVES: Recent studies showed the therapeutic benefit of lymphadenectomy in advanced stage urothelial carcinoma of the upper urinary tract, but there is still a lack of prospective studies and standardization of the extent of lymphadenectomy. The aim of this multi-institutional study was to examine the role of lymphadenectomy in urothelial carcinoma of the upper urinary tract. METHODS: From January 2005 to September 2012, 77 patients undergoing nephroureterectomy and lymphadenectomy for non-metastatic (cN0M0) urothelial carcinoma of the upper urinary tract were included in a prospective study at two Japanese institutions(lymphadenectomy group). Lymphadenectomies were carried out according to definite anatomical template. Results from this group were compared with those from a control group of 89 patients who did not receive lymphadenectomy during the study period (no lymphadenectomy group). RESULTS: In patients with urothelial carcinoma of the upper urinary tract in the renal pelvis of pathological stage 2 or higher, template-based lymphadenectomy resulted in significantly higher cancer-specific survival (89.8% and 51.7%, P = 0.01) and overall survival (86.1% and 48.0%, P = 0.01). Disease-free survival tended to be higher in the lymphadenectomy group(77.8% and 50.0%, P = 0.06). Template-based lymphadenectomy was a significant independent factor for reducing the risk of cancer death in patients with renal pelvic cancer of ≥ pT2 by multivariate analysis. In contrast, cancer-specific survival of patients with ureteral urothelial carcinoma of the upper urinary tract was not significantly different between the lymphadenectomy and no lymphadenectomy groups. CONCLUSIONS: This multi-institutional prospective study further supports the therapeutic role of template-based lymphadenectomy in patients with advanced-stage urothelial carcinoma of the upper urinary tract in the renal pelvis. This is not the case for patients with ureteral urothelial carcinoma of the upper urinary tract.
OBJECTIVES: Recent studies showed the therapeutic benefit of lymphadenectomy in advanced stage urothelial carcinoma of the upper urinary tract, but there is still a lack of prospective studies and standardization of the extent of lymphadenectomy. The aim of this multi-institutional study was to examine the role of lymphadenectomy in urothelial carcinoma of the upper urinary tract. METHODS: From January 2005 to September 2012, 77 patients undergoing nephroureterectomy and lymphadenectomy for non-metastatic (cN0M0) urothelial carcinoma of the upper urinary tract were included in a prospective study at two Japanese institutions(lymphadenectomy group). Lymphadenectomies were carried out according to definite anatomical template. Results from this group were compared with those from a control group of 89 patients who did not receive lymphadenectomy during the study period (no lymphadenectomy group). RESULTS: In patients with urothelial carcinoma of the upper urinary tract in the renal pelvis of pathological stage 2 or higher, template-based lymphadenectomy resulted in significantly higher cancer-specific survival (89.8% and 51.7%, P = 0.01) and overall survival (86.1% and 48.0%, P = 0.01). Disease-free survival tended to be higher in the lymphadenectomy group(77.8% and 50.0%, P = 0.06). Template-based lymphadenectomy was a significant independent factor for reducing the risk of cancer death in patients with renal pelvic cancer of ≥ pT2 by multivariate analysis. In contrast, cancer-specific survival of patients with ureteral urothelial carcinoma of the upper urinary tract was not significantly different between the lymphadenectomy and no lymphadenectomy groups. CONCLUSIONS: This multi-institutional prospective study further supports the therapeutic role of template-based lymphadenectomy in patients with advanced-stage urothelial carcinoma of the upper urinary tract in the renal pelvis. This is not the case for patients with ureteral urothelial carcinoma of the upper urinary tract.
Authors: Meera R Chappidi; Max Kates; Michael H Johnson; Noah M Hahn; Trinity J Bivalacqua; Phillip M Pierorazio Journal: Urol Oncol Date: 2016-07-27 Impact factor: 3.498
Authors: Thomas Seisen; Shahrokh F Shariat; Olivier Cussenot; Benoit Peyronnet; Raphaële Renard-Penna; Pierre Colin; Morgan Rouprêt Journal: World J Urol Date: 2016-01-25 Impact factor: 4.226
Authors: Victor M Schuettfort; Benjamin Pradere; Fahad Quhal; Hadi Mostafaei; Ekaterina Laukhtina; Keiichiro Mori; Reza Sari Motlagh; Michael Rink; David D'Andrea; Mohammad Abufaraj; Pierre I Karakiewicz; Shahrokh F Shariat Journal: Turk J Urol Date: 2020-10-09