Alessandro Nini1,2, Alessandro Larcher1,2, Walter Cazzaniga1,2, Paolo Dell'Oglio1,2, Francesco Cianflone1,2, Fabio Muttin1,2, Francesco Ripa1,2, Andrea Salonia1,2, Alberto Briganti1,2, Francesco Montorsi1,2, Roberto Bertini1,2, Umberto Capitanio3,4. 1. Unit of Urology, University Vita-Salute San Raffaele, IRCCS San Raffaele Scientific Institute, Via Olgettina 60, 20132, Milan, Italy. 2. Renal Cancer Unit, Division of Oncology, URI, Urological Research Institute, IRCCS San Raffaele Scientific Institute, Via Olgettina 60, 20132, Milan, Italy. 3. Unit of Urology, University Vita-Salute San Raffaele, IRCCS San Raffaele Scientific Institute, Via Olgettina 60, 20132, Milan, Italy. umbertocapitanio@gmail.com. 4. Renal Cancer Unit, Division of Oncology, URI, Urological Research Institute, IRCCS San Raffaele Scientific Institute, Via Olgettina 60, 20132, Milan, Italy. umbertocapitanio@gmail.com.
Abstract
PURPOSE: To evaluate the role of side and location of the primary renal cell carcinoma (RCC) on the risk of lymph node invasion (LNI) and/or nodal progression (NP) during follow-up. MATERIALS AND METHODS: We evaluated 2485 patients with unilateral RCC, surgically treated in a single tertiary care referral center. Outcomes were LNI at surgery and/or NP during follow-up. We studied if RCC side (left vs. right) and location (upper vs. middle vs. hilar vs. lower area vs. more than one area) affected the probability of LNI and/or NP at follow-up. RESULTS: Overall, 43 and 15% of patients underwent lymph node dissection and had LNI at surgery, respectively. During follow-up, 2.2% of patients had NP. Higher rates of LNI and NP were observed for patients with primary tumor located in more than one anatomical kidney area relative to patients with tumor in a single area (upper 11% vs. middle 10% vs. hilar 0%, vs. lower 12% vs. more than one area 26%, p < 0.01). cM1, cN1, pT2/pT3/pT4 disease and Fuhrman grade 3/4 were independent predictors of the study outcome (all p ≤ 0.01). Neither the RCC side nor the location reached the independent predictor status (all p > 0.1). CONCLUSIONS: Patients with single-side and more than one anatomical kidney area affected by RCC have higher rate of LNI at surgery and/or NP at follow-up. Neither side nor location of primary RCC tumor is related to the risk of harboring LNI at surgery and/or developing NP at follow-up.
PURPOSE: To evaluate the role of side and location of the primary renal cell carcinoma (RCC) on the risk of lymph node invasion (LNI) and/or nodal progression (NP) during follow-up. MATERIALS AND METHODS: We evaluated 2485 patients with unilateral RCC, surgically treated in a single tertiary care referral center. Outcomes were LNI at surgery and/or NP during follow-up. We studied if RCC side (left vs. right) and location (upper vs. middle vs. hilar vs. lower area vs. more than one area) affected the probability of LNI and/or NP at follow-up. RESULTS: Overall, 43 and 15% of patients underwent lymph node dissection and had LNI at surgery, respectively. During follow-up, 2.2% of patients had NP. Higher rates of LNI and NP were observed for patients with primary tumor located in more than one anatomical kidney area relative to patients with tumor in a single area (upper 11% vs. middle 10% vs. hilar 0%, vs. lower 12% vs. more than one area 26%, p < 0.01). cM1, cN1, pT2/pT3/pT4 disease and Fuhrman grade 3/4 were independent predictors of the study outcome (all p ≤ 0.01). Neither the RCC side nor the location reached the independent predictor status (all p > 0.1). CONCLUSIONS:Patients with single-side and more than one anatomical kidney area affected by RCC have higher rate of LNI at surgery and/or NP at follow-up. Neither side nor location of primary RCC tumor is related to the risk of harboring LNI at surgery and/or developing NP at follow-up.
Entities:
Keywords:
Kidney cancer; Lymph node invasion; Metastases; Renal cancer
Authors: Amir M Sherif; Elisabeth Eriksson; Magnus Thörn; Janos Vasko; Katrine Riklund; Lars Ohberg; Börje J Ljungberg Journal: BJU Int Date: 2011-08-24 Impact factor: 5.588
Authors: Umberto Capitanio; Claudio Jeldres; Jean-Jacques Patard; Paul Perrotte; Laurent Zini; Alexandre de La Taille; Vincenzo Ficarra; Luca Cindolo; Karim Bensalah; Walter Artibani; Jacques Tostain; Antoine Valeri; Richard Zigeuner; Arnaud Méjean; Jean Luc Descotes; Eric Lechevallier; Peter F Mulders; Herve Lang; Didier Jacqmin; Pierre I Karakiewicz Journal: BJU Int Date: 2008-10-16 Impact factor: 5.588