The rationale and the role of lymph node dissection in renal cell carcinoma

Capitanio, Umberto; Leibovich, Bradley C.

doi:10.1007/s00345-016-1886-3

Cited by 35 publications

(25 citation statements)

References 57 publications

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“…In current practice, lymph nodes are not routinely dissected by urologists in all RCC cases, as the benefit for cancer control is not entirely proven, and because stage migration has resulted in an increased proportion of very low‐risk tumours . Rather, a selective approach is usually used for those with clinical concern, with lymph node dissection being performed in <5% of surgeries for renal cancer . Nonetheless, there are some patients who experience long‐term survival after resection of isolated lymph node metastases .…”

Section: Lymph Nodesmentioning

confidence: 99%

“…In current practice, lymph nodes are not routinely dissected by urologists in all RCC cases, 56,57 as the A B C D Figure 9. Perinephric invasion can manifest as mushroom-shaped tumour outpouchings (A) (B, higher magnification) into the plane of the fat.…”

Section: Lymph Nodesmentioning

confidence: 99%

“…57 Rather, a selective approach is usually used for those with clinical concern, with lymph node dissection being performed in <5% of surgeries for renal cancer. 57 Nonetheless, there are some patients who experience long-term survival after resection of isolated lymph node metastases. 58 In routine nephrectomy specimens without accompanying dissection of regional lymph nodes, identification of incidental lymph nodes in the hilar area is generally uncommon.…”

Section: Lymph Nodesmentioning

confidence: 99%

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Renal cell carcinoma staging: pitfalls, challenges, and updates

2018

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Renal cell carcinoma (RCC) is unusual among cancers in that it often grows as a spherical, well‐circumscribed mass. Increasing tumour size influences the pathological pT stage category within pT1 and pT2, with cutoffs of 40, 70 and 100 mm; however, with increasing size also comes a sharp increase in the likelihood of renal sinus or renal vein tributary invasion, such that clear cell RCC rarely reaches 70 mm without invading one of these. To clarify some previous challenges in assigning tumour stage, the American Joint Committee on Cancer 2016 tumor–node–metastasis classification has removed the requirements than vein invasion be recognised grossly and that vein walls contain muscle for the diagnosis of vein invasion. Renal pelvis invasion has also been added as an additional route to pT3a. Multinodularity or finger‐like extensions from a renal mass should be viewed with great suspicion for the possibility of vein or renal sinus invasion, and, as tumour size increases to over 40–50 mm, thorough sampling of the renal sinus interface should always be undertaken. With increasing interest in adjuvant therapy in renal cancer, the pathologist's role in RCC staging will continue to be an important prognostic parameter and a tool for selection of patients for enrolment in clinical trials.

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Section: Lymph Nodesmentioning

confidence: 99%

Section: Lymph Nodesmentioning

confidence: 99%

Section: Lymph Nodesmentioning

confidence: 99%

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Renal cell carcinoma staging: pitfalls, challenges, and updates

2018

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“…Therefore, if cytoreductive surgery is contemplated, such patients should also undergo removal of such LNs [Table IV]. [121314]…”

Section: Defining Clinical Cohort and Practice Of Expert Group Panel mentioning

confidence: 99%

Oncology Gold StandardTM practical consensus recommendations 2016 for treatment of advanced clear cell renal cell carcinoma

Batra

Parikh

Prabhash

et al. 2016

South Asian J Cancer

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The Oncology Gold Standard (OGS) Expert Group on renal cell carcinoma (RCC) developed the consensus statement to provide community oncologists practical guidelines on the management of advanced clear cell (cc) RCC using published evidence, practical experience of experts in real life management, and results of a nationwide survey involving 144 health-care professionals. Six broad question categories containing 33 unique questions cover major situations in the routine management of RCC. This document serves as a ready guide for the standard of care to optimize outcome. The table of “Take Home Messages” at the end is a convenient tool for busy practitioners.

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“…Capitanio and Leibovich addressed both "The rationale and role of lymph node dissection in renal cell carcinoma [1]." The review analyzes the findings of the prospective, randomized study, EORTC 30,881, which showed no survival benefit among imaging with PSMA and histologic assessment, various dosing of the radiotracers as well as patient outcomes.…”

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confidence: 99%