Effect of Lymphadenectomy During Radical Nephroureterectomy in Locally Advanced Upper Tract Urothelial Carcinoma

Ikeda, Masaomi; Matsumoto, Kazumasa; Sakaguchi, Kazushige; Ishii, Daisuke; Tabata, Ken‐ichi; Kurosawa, Kazuhiro; Urakami, Shinji; Okaneya, Toshikazu

doi:10.1016/j.clgc.2017.04.004

Cited by 13 publications

(26 citation statements)

References 14 publications

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“…There were no randomised controlled trials (RCTs). In all, 21 studies [24][25][26][27][28][29][30]32,33,36,38,39,[41][42][43][44][45][46][47][48][49] collected data retrospectively, one paper [37] collected data prospectively, and one paper [31] collected data both retrospectively and prospectively. In all, 17 papers included details of cohorts who had not undergone LND as a comparative cohort [24,27,28,[31][32][33][35][36][37][39][40][41][42][43]45,47,50].…”

Section: Resultsmentioning

confidence: 99%

“…In all, 23 papers [24][25][26]28,[30][31][32][33][34][35][36][37][38][39][40][41][42][43][44]46,47,49,50] included patients regardless of pT stage, two papers included patients only with pT2-4 disease [27,29], and one paper only included patients with pT4 disease [48]. One paper [45] did not include data on pT stage of the patients included.…”

Section: Patient Demographicsmentioning

confidence: 99%

“…In all, 12 studies presented data on RFS after LND [26,28,[30][31][32]36,[41][42][43][47][48][49]. Most of these papers reported RFS at 5 years from surgery.…”

Section: Characteristics Of Included Studiesmentioning

confidence: 99%

“…Most of these papers reported RFS at 5 years from surgery. Eight studies provided 5-year RFS comparing patients who underwent LND (1792 patients) with patients who did not (3017) [28,32,36,39,[41][42][43]47].…”

Section: Characteristics Of Included Studiesmentioning

confidence: 99%

“…In all, 16 papers reported CSS [26,28,[30][31][32]34,36,37,[39][40][41][42][43]45,48,49]. Nine studies provided 5-year CSS comparing patients who underwent LND (3628 patients) with patients who did not (3597) [28,33,36,[39][40][41][42][43]45].…”

Section: Characteristics Of Included Studiesmentioning

confidence: 99%

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Lymph node dissection during nephroureterectomy: Establishing the existing evidence based on a review of the literature

Grimes

McKay

Lee

et al. 2019

Arab Journal of Urology

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To determine the role of lymph node dissection (LND) in the treatment of upper tract transitional cell carcinoma (UTTCC), as the role of LND along with nephroureterectomy in treating UTTCC is unclear and several retrospective studies have been published on this topic with conflicting results. Methods: The Medical Literature Analysis and Retrieval System Online (MEDLINE), the Excerpta Medica dataBASE (EMBASE), Cochrane Central Register of Controlled Trials database (CENTRAL), Cumulative Index to Nursing and Allied Health Literature (CINAHL), Clinicaltrials. gov, Google Scholar, and individual urological journals, were searched for all studies investigating the role of LND in the treatment of UTTCC. Of the studies identified, those that met inclusion criteria were included in this review. Results: In all, 27 studies were included in this review, with 9303 patients who underwent LND. No randomised controlled trials (RCTs) were identified. Tumours were located in the renal pelvis in 62% of patients, in the ureter in 35.5%, and multifocal in 2.3%. In total: 77.1% were LN-negative and 22.9% had LN metastasis. For all patients undergoing LND, the 5-year recurrence-free survival (RFS) and cancer-specific survival (CSS) rates were 27-65.4% and 32.3-95%, respectively. For patients who underwent a LND in accordance with a standardised anatomical template, the 5-year RFS and CSS rates were 84.3-93% and 83.5-94%, respectively. Conclusion: LND may provide a survival benefit in patients undergoing nephroureterectomy for UTTCC, particularly if following a standardised anatomical template and in those patients with muscle-invasive disease; however, a prospective RCT is required to confirm this.

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Section: Resultsmentioning

confidence: 99%

Section: Patient Demographicsmentioning

confidence: 99%

“…In all, 12 studies presented data on RFS after LND [26,28,[30][31][32]36,[41][42][43][47][48][49]. Most of these papers reported RFS at 5 years from surgery.…”

Section: Characteristics Of Included Studiesmentioning

confidence: 99%

Section: Characteristics Of Included Studiesmentioning

confidence: 99%

Section: Characteristics Of Included Studiesmentioning

confidence: 99%

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Lymph node dissection during nephroureterectomy: Establishing the existing evidence based on a review of the literature

Grimes

McKay

Lee

et al. 2019

Arab Journal of Urology

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Lymph Node Dissection in Upper Tract Urothelial Carcinoma: Current Status and Future Perspectives

Dłubak,

Karwacki,

Logoń

et al. 2023

Curr Oncol Rep

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Purpose of Review This narrative review aims to evaluate the role of lymph node dissection (LND) in upper tract urothelial carcinoma (UTUC) and its implications for staging and management outcomes, as well as future perspectives. Recent Findings Multiple studies have demonstrated the limitations of conventional imaging techniques in accurately localizing lymph node metastasis (LNM) in UTUC. While 18F-fluorodeoxyglucose positron emission tomography with computed tomography (18FDG-PET/CT) shows promise for preoperative LNM detection, its specificity is low. Alternative methods such as choline PET/CT and sentinel lymph node detection are under consideration but require further investigation. Additionally, various preoperative factors associated with LNM hold potential for predicting nodal involvement, thereby improving nodal staging and oncologic outcomes of LND. Several surgical approaches, including segmental ureterectomy and robot-assisted nephroureterectomy, provide a possibility for LND, while minimizing morbidity. Summary LND remains the primary nodal staging tool for UTUC, but its therapeutic benefit is still uncertain. Advances in imaging techniques and preoperative risk assessment show promise in improving LNM detection. Further research and multi-center studies are needed to comprehensively assess the advantages and limitations of LND in UTUC, as well as the long-term outcomes of alternative staging and treatment strategies.

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An Analysis of Staging and Treatment Trends for Upper Tract Urothelial Carcinoma in the National Cancer Database

Browne

Stensland

Moynihan

et al. 2018

Clinical Genitourinary Cancer

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Effect of Lymphadenectomy During Radical Nephroureterectomy in Locally Advanced Upper Tract Urothelial Carcinoma

Cited by 13 publications

References 14 publications

Lymph node dissection during nephroureterectomy: Establishing the existing evidence based on a review of the literature

Lymph node dissection during nephroureterectomy: Establishing the existing evidence based on a review of the literature

Lymph Node Dissection in Upper Tract Urothelial Carcinoma: Current Status and Future Perspectives

An Analysis of Staging and Treatment Trends for Upper Tract Urothelial Carcinoma in the National Cancer Database

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