Medizinische Universität Graz Austria/Österreich - Forschungsportal - Medical University of Graz
Gewählte Publikation:
SHR Neuro Krebs Kardio Lipid Stoffw Microb
Tilki, D; Chandrasekar, T; Capitanio, U; Ciancio, G; Daneshmand, S; Gontero, P; Gonzalez, J; Haferkamp, A; Hohenfellner, M; Huang, WC; Linares Espinós, E; Lorentz, A; Martinez-Salamanca, JI; Master, VA; McKiernan, JM; Montorsi, F; Novara, G; Pahernik, S; Palou, J; Pruthi, RS; Rodriguez-Faba, O; Russo, P; Scherr, DS; Shariat, SF; Spahn, M; Terrone, C; Vera-Donoso, C; Zigeuner, R; Libertino, JA; Evans, CP.
Impact of lymph node dissection at the time of radical nephrectomy with tumor thrombectomy on oncological outcomes: Results from the International Renal Cell Carcinoma-Venous Thrombus Consortium (IRCC-VTC).
Urol Oncol. 2018; 36(2):79.e11-79.e79
Doi: 10.1016/j.urolonc.2017.10.008
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- Co-Autor*innen der Med Uni Graz
- Zigeuner Richard
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- Abstract:
- To study the effect of lymph node dissection (LND) at the time of nephrectomy and tumor thrombectomy on oncological outcomes in patients with renal cell carcinoma (RCC) and tumor thrombus. The records of 1,978 patients with RCC and tumor thrombus who underwent radical nephrectomy and tumor thrombectomy from 1985 to 2014 at 24 centers were analyzed. None of the patients had distant metastases. Extent and pathologic results of LND were compared with respect to cancer-specific survival (CSS). Multivariable Cox regression models were used to quantify the effect of multiple covariates. LND was performed in 1,026 patients. In multivariable analysis, the presence of LN metastasis, the number of positive LNs, and LN density were independently associated with cancer-specific mortality (CSM). Clinical node-negative (cN-) disease was documented in 573 patients, 447 of them underwent LND with 43 cN- patients (9.6%) revealing positive LNs at pathology. LN positive cN- patients showed significantly better CSS when compared to LN positive cN+ patients. In multivariable analysis, positive cN status in LN positive patients was a significant predictor of CSM (HR, 2.923; P = 0.015). The number of positive nodes harvested during LND and LN density was strong prognostic indicators of CSS, while number of removed LNs did not have a significant effect on CSS. The rate of pN1 patients among clinically node-negative patients was relatively high, and LND in these patients suggested a survival benefit. However, only a randomized trial can determine the absolute benefit of LND in this setting. Copyright © 2018 Elsevier Inc. All rights reserved.
- Find related publications in this database (Keywords)
- Renal cell carcinoma
- Lymph node metastasis
- Vena cava tumor thrombectomy
- Lymphadenectomy
- Survival
- Inferior vena cava