Luis Dominguez-Escrig, Jose and Peyronnet, Benoit and Seisen, Thomas and Bruins, Harman M. and Yuan, Cathy Yuhong and Babjuk, Marko and Boehle, Andreas and Burger, Maximilian and Comperat, Eva M. and Gontero, Paolo and Lam, Thomas and MacLennan, Steven and Mostafid, Hugh and Palou, Joan and van Rhijn, Bas W. G. and Sylvester, Richard J. and Zigeuner, Richard and Shariat, Shahrokh F. and Roupret, Morgan (2019) Potential Benefit of Lymph Node Dissection During Radical Nephroureterectomy for Upper Tract Urothelial Carcinoma: A Systematic Review by the European Association of Urology Guidelines Panel on Non-muscle-invasive Bladder Cancer. EUROPEAN UROLOGY FOCUS, 5 (2). pp. 224-241. ISSN 2405-4569
Full text not available from this repository. (Request a copy)Abstract
Context: The oncological efficacy of routine lymphadenectomy (lymph node dissection [LND]) at the time of radical nephroureterectomy (RNU) remains controversial. Objective: To systematically review the available literature assessing the impact of LND in upper tract urothelial carcinoma (UTUC) patients. Evidence acquisition: Embase, Medline, and Cochrane databases were searched for all studies comparing outcomes of patients undergoing RNU without LND versus any form of LND. We identified nine retrospective studies eligible for inclusion in this systematic review. We took cancer-specific survival (CSS) as the primary end point, and performed a narrative review and risk of bias assessment. Evidence synthesis: Six studies compared outcomes of no LND versus LND. Three studies compared complete LND versus incomplete LND versus no LND. The incidence of pN+ in patients with high-stage (>= pT2) tumours ranged from 14.3% to 40%. Pre- and postoperative characteristics differed among the study groups, potentially biasing the results, as demonstrated by the risk of bias assessment, potentially favouring the LND group. Oncological outcomes such as cancer-specific, overall, recurrence-free, and metastasis-free survival were reviewed, demonstrating a survival benefit with LND in high-stage disease of the renal pelvis. Conclusions: Template-based and complete LND improves CSS in patients with high-stage (>= pT2) UTUC and reduces the risk of local recurrence. The impact of LND in ureteral tumours remains uncertain. Patient summary: Studies comparing radical nephroureterectomy with or without the removal of nodes (lymph node dissection [LND]) were analysed. LND improves survival in patients with high-stage disease of the renal pelvis, if it is performed according to an anatomical template-based approach. (c) 2017 European Association of Urology. Published by Elsevier B.V. All rights reserved.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | UPPER URINARY-TRACT; TRANSITIONAL-CELL CARCINOMA; TEMPLATE-BASED LYMPHADENECTOMY; NEOADJUVANT CHEMOTHERAPY; ONCOLOGICAL OUTCOMES; CLINICAL-TRIAL; IMPACT; METAANALYSIS; CYSTECTOMY; SURVIVAL; Recurrence; Urothelial carcinoma; Renal pelvis; Ureter; Survival; Nodes; Metastasis |
| Subjects: | 600 Technology > 610 Medical sciences Medicine |
| Divisions: | Medicine > Lehrstuhl für Urologie |
| Depositing User: | Petra Gürster |
| Date Deposited: | 27 Mar 2020 08:44 |
| Last Modified: | 27 Mar 2020 08:44 |
| URI: | https://pred.uni-regensburg.de/id/eprint/27393 |
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