Lymph node dissection during cytoreductive nephrectomy: a retrospective analysis.
Lymph node dissection during cytoreductive nephrectomy: a retrospective analysis.
复制标题
DOI：
10.1111/iju.12457
复制
发表时间：
2014-09
期刊：
影响因子：
--
通讯作者：
Russo P
中科院分区：
文献类型：
--
作者：
Feuerstein MA;Kent M;Bernstein M;Russo P
To assess whether regional lymph node dissection (LND) could improve the prognosis of patients with metastatic renal cell carcinoma (RCC). We reviewed data on 258 patients who underwent cytoreductive nephrectomy at our institution, some of whom received a concurrent LND. Primary outcome measure was overall survival. A Cox proportional hazards regression model included, age, pathologic stage, lymphadenopathy, tumor size, modified MSKCC criteria, site of metastatic disease, and LND. We created a logistic regression model to evaluate risk factors for node-positive disease. Survival analyses were performed for lymph node template (hilar vs other) and number of nodes removed (0–3, 4–7, or ≥8). Of 258 patients, 177 (69%) underwent LND, and positive nodes were found in 59 (33%). Five-year overall survival was 21% for patients who underwent LND and 31% for patients who did not. We found no significant difference in survival among patients receiving or not receiving LND. Five-year overall survival was 27% and 9% for negative and positive nodal status, respectively (p <0.0005). For patients who underwent LND, the presence of lymphadenopathy was a significant predictor of node-positive disease (odds ratio 25.0, 95% CI 9.04–69.4, p <0.0001). LND performed during cytoreductive nephrectomy was not associated with a survival benefit. Lymph node–positive disease was identified as a poor prognostic variable; therefore, LND should be considered as a staging procedure for clinical trials.
登录
查看更多内容
影响因子：
168.9
作者：
Mickisch, GHJ;Garin, A;Sylvester, R
通讯作者：
Sylvester, R
影响因子：
4.5
作者：
Silberstein JL;Adamy A;Maschino AC;Ehdaie B;Garg T;Favaretto RL;Ghoneim TP;Motzer RJ;Russo P
通讯作者：
Russo P
影响因子：
6.4
作者：
Hutterer, Georg C.;Patard, Jean-Jacques;Karakiewicz, Pierre I.
通讯作者：
Karakiewicz, Pierre I.
影响因子：
6.6
作者：
STUDER, UE;SCHERZ, S;ZINGG, EJ
通讯作者：
ZINGG, EJ
影响因子：
6.6
作者：
Flanigan, RC;Mickisch, G;Crawford, ED
通讯作者：
Crawford, ED