Potential benefit of lymph node dissection during radical nephrectomy for kidney cancer: A review and critical analysis of current literature

Marchioni M., Amparore D., Magli I. A., Bertolo R., Carbonara U., ERDEM S., ...Daha Fazla

Asian Journal of Urology, cilt.9, sa.3, ss.215-226, 2022 (ESCI) identifier identifier identifier

  • Yayın Türü: Makale / Derleme
  • Cilt numarası: 9 Sayı: 3
  • Basım Tarihi: 2022
  • Doi Numarası: 10.1016/j.ajur.2022.03.007
  • Dergi Adı: Asian Journal of Urology
  • Derginin Tarandığı İndeksler: Emerging Sources Citation Index (ESCI), Scopus
  • Sayfa Sayıları: ss.215-226
  • Anahtar Kelimeler: Renal cell carcinoma, Lymph node dissection, Radical nephrectomy, Salvage lymph node dissection, RENAL-CELL CARCINOMA, ASSISTED PARTIAL NEPHRECTOMY, HIGH-RISK, CYTOREDUCTIVE NEPHRECTOMY, PROGNOSTIC-SIGNIFICANCE, ACTIVE SURVEILLANCE, SURVIVAL, INVASION, SURGERY, LYMPHADENECTOMY
  • Kocaeli Üniversitesi Adresli: Hayır

Özet

© 2022 Editorial Office of Asian Journal of UrologyObjective: The role of lymph node dissection (LND) is still controversial in patients with renal cell carcinoma undergoing surgery. We aimed to provide a comprehensive review of the literature about the effect of LND on survival, prognosis, surgical outcomes, as well as patient selection and available LND templates. Methods: Recent literature (from January 2011 to December 2021) was assessed through PubMed and MEDLINE databases. A narrative review of most relevant articles was provided. Results: The frequencies in which LNDs are being carried out are decreasing due to an increase in minimally invasive and nephron sparing surgery. Moreover, randomized clinical trials and meta-analyses failed to show any survival advantage of LND versus no LND. However, retrospective studies suggest a survival benefit of LND in high-risk patients (bulky tumors, T3-4 stage, and cN1 patients). Moreover, extended LND might provide important staging information, which could be of interest for adjuvant treatment planning. Conclusion: No level 1 evidence of any survival advantage deriving from LND is currently available in literature. Thus, the role of LND is limited to staging purposes. However, low grade evidence suggests a possible role of LND in high-risk patients. Randomized clinical trials are warranted to corroborate these findings.