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Clinical Significance of Lymph Node Dissection in Patients with Muscle-Invasive Upper Urinary Tract Transitional Cell Carcinoma Treated with Nephroureterectomy

Authors
 Kang Su Cho  ;  Hyun Min Choi  ;  Kyochul Koo  ;  Sung Jin Park  ;  Koon Ho Rha  ;  Young Deuk Choi  ;  Byung Ha Chung  ;  Nam Hoon Cho  ;  Seung Choul Yang  ;  Sung Joon Hong 
Citation
 JOURNAL OF KOREAN MEDICAL SCIENCE, Vol.24(4) : 674-678, 2009 
Journal Title
 JOURNAL OF KOREAN MEDICAL SCIENCE 
ISSN
 1011-8934 
Issue Date
2009
MeSH
Aged ; Aged, 80 and over ; Carcinoma, Transitional Cell/mortality ; Carcinoma, Transitional Cell/surgery* ; Carcinoma, Transitional Cell/therapy ; Female ; Humans ; Kidney Neoplasms/mortality ; Kidney Neoplasms/surgery* ; Kidney Neoplasms/therapy ; Lymph Node Excision* ; Male ; Middle Aged ; Neoplasm Staging ; Nephrectomy ; Recurrence ; Retrospective Studies ; Survival Analysis ; Ureteral Neoplasms/mortality ; Ureteral Neoplasms/surgery* ; Ureteral Neoplasms/therapy
Keywords
Carcinoma, Transitional Cell ; Kidney Pelvis ; Lymph Node Excision ; Recurrence ; Ureter
Abstract
We investigated the value of lymph node dissection in patients with cN0 muscle-invasive transitional cell carcinoma of the upper urinary tract (UUT-TCC). Medical records of 152 patients with cN0 muscle-invasive UUT-TCC, who underwent nephroureterectomy between 1986 and 2005, were reviewed. Sixty-three patients (41.4%) underwent lymph node dissection. The median number of lymph nodes harvested was 6 (range, 1 to 35), and from these, lymph node involvement was confirmed in 9 patients (14.3%). Locoregional recurrence (LR) and disease-recurrence (DR) occurred in 29 patients and 63 patients, respectively. Fifty-five patients (36.2%) had died of cancer at the last follow-up. The number of lymph nodes harvested was associated with the reduction of LR (chi-square(trend)=6.755, P=0.009), but was not associated with DR (chi-square(trend)=1.558, P=0.212). In the survival analysis, N stage (P=0.0251) and lymph node dissection (P=0.0073) had significant influence on LR, but not on DR or disease-specific survival. However, the number of lymph nodes harvested did not affect LR-free, DR-free, or disease-specific survival. We conclude that lymph node dissection may improve the control of locoregional cancer, as well as staging accuracy, in cN0 muscle-invasive UUT-TCC, but that it does not clearly influence survival
Files in This Item:
T200902584.pdf Download
DOI
10.3346/jkms.2009.24.4.674
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Urology (비뇨의학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Pathology (병리학교실) > 1. Journal Papers
Yonsei Authors
Koo, Kyo Chul(구교철) ORCID logo https://orcid.org/0000-0001-7303-6256
Rha, Koon Ho(나군호) ORCID logo https://orcid.org/0000-0001-8588-7584
Yang, Seung Choul(양승철)
Chung, Byung Ha(정병하) ORCID logo https://orcid.org/0000-0001-9817-3660
Cho, Kang Su(조강수) ORCID logo https://orcid.org/0000-0002-3500-8833
Cho, Nam Hoon(조남훈) ORCID logo https://orcid.org/0000-0002-0045-6441
Choi, Young Deuk(최영득) ORCID logo https://orcid.org/0000-0002-8545-5797
Hong, Sung Joon(홍성준) ORCID logo https://orcid.org/0000-0001-9869-065X
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/104336
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