Impact of Lymph Node Dissection on Cancer Specific Survival in Patients With Upper Tract Urothelial Carcinoma Treated With Radical Nephroureterectomy
Impact of Lymph Node Dissection on Cancer Specific Survival in Patients With Upper Tract Urothelial Carcinoma Treated With Radical Nephroureterectomy
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DOI：
10.1016/j.juro.2009.02.021
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发表时间：
2009-06-01
影响因子：
6.6
通讯作者：
Montorsi, Francesco
中科院分区：
文献类型：
--
作者：
Roscigno, Marco;Shariat, Shahrokh F.;Montorsi, Francesco
目的：研究淋巴清扫对上尿路癌根治性肾输尿管切除术患者临床预后的影响。材料和方法：收集全球13个中心连续1130例PT1-4上尿路癌根治性肾输尿管切除术患者的资料。患者按结节状态分组(pN0、pNx、Pn+)。进行淋巴清扫的选择是由治疗外科医生决定的。所有病理切片都由专职的泌尿生殖病理学家重新评估。结果：412例患者(36.5%)为PNO病，578例为PNX病(51.1%)，140例为PN+病(12.4%)。PN+患者的5年癌症特异性生存估计低于PNX患者(35%比69%，P<0.05)。
Purpose: We examined the impact of lymphadenectomy on the clinical outcomes of patients with upper tract urothelial cancer treated with radical nephroureterectomy.Materials and Methods: Data were collected on 1,130 consecutive patients with pT1-4 upper tract urothelial cancer treated with radical nephroureterectomy at 13 centers worldwide. Patients were grouped according to nodal status (pN0 vs pNx vs pN+). The choice to perform lymphadenectomy was determined by the treating surgeon. All pathology slides were reevaluated by dedicated genitourinary pathologists. Univariable and multivariable Cox regression models measured the association of nodal status (pN0 vs pNx vs pN+) with cancer specific survival.Results: Overall 412 patients (36.5%) had pNO disease, 578 had pNx disease (51.1%) and 140 had pN+ disease (12.4%). The 5-year cancer specific survival estimate was lower in patients with pN+ compared to those with pNx disease (35% vs 69%, p