Trends of lymphadenectomy in upper tract urothelial carcinoma (UTUC) patients treated with radical nephroureterectomy

M. Moschini, B. Foerster, M. Abufaraj, F. Soria, T. Seisen, M. Roupret, P. Colin, A. De la Taille, B. Peyronnet, K. Bensalah, R. Herout, M. P. Wirth, V. Novotny, P. Chlosta, M. Bandini, F. Montorsi, G. Simone, M. Gallucci, G. Romeo, K. MatsumotoP. Karakiewicz, A. Briganti, S. F. Shariat

Research output: Contribution to journalArticlepeer-review

Abstract

INTRODUCTION: To evaluate temporal trends in the delivery and extent of lymphadenectomy (LND) in radical nephroureterectomy (RNU) performed in upper tract urothelial carcinoma (UTUC) patients. METHODS: We evaluated a multi institutional collaborative database composed by 1512 consecutive patients diagnosed with UTUC treated with RNU between 1990 and 2016. Year of surgery were grouped in five periods: 1990-1996, 1997-2002, 2003-2007, 2008-2012 and 2013-2016. Data about LND were available for all patients and numbers of nodes removed and positive were reported by dedicate uropathologists. The Mann-Whitney and Chi square tests were used to compare the statistical significance of differences in medians and proportions, respectively. RESULTS: Five hundred forty-five patients (36.0%) received a concomitant LND while 967 (64.0%) did not; 41.9% of open RNU patients received a concomitant LND compared to 24.4% of laparoscopic RNU patients. The rate of concomitant LND increased with time in the overall, laparoscopic and open RNU patients (all p 0.1). CONCLUSION: Although an increased trend was observed, most patients treated with RNU did not receive LND. Surgeons using a laparoscopic RNU were less likely to perform a concomitant LND, and when done, they remove less nodes.
Original languageEnglish
Pages (from-to)1541-1547
Number of pages7
JournalWorld Journal of Urology
Volume35
Issue number10
DOIs
Publication statusPublished - Oct 1 2017

Keywords

  • Lymph node metastases
  • Lymphadenectomy
  • Radical nephroureterectomy
  • UTUC
  • Upper tract urothelial carcinoma

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