The role of lymphadenectomy in the radical nephrectomy for renal cell carcinoma.
BACKGROUND
The value of lymphadenectomy in the management of renal cell carcinoma (RCC) remains controversial. Most would agree that lymphadenectomy (LD) provides accurate pathologic staging for prognostic data. The question remains whether there is any significant therapeutic benefit from extensive lymph node dissection with radical nephrectomy. The aim of this study was to compare outcomes in sampled lymphadenectomy (SLD) and extensive lymphadenectomy (ELD) with radical nephrectomy for RCC.


METHODS
One hundred and thirty-seven patients with RCC were enrolled in this study from Oct. 1982 to Dec. 1996. Eighty-one patients received radical nephrectomy with SLD (stage I: 43, II: 16, III: 22). Fifty-six patients received radical nephrectomy with ELD (stage I: 30, II: 11, III: 15).


RESULTS
The mean number of lymph nodes removed by SLD was 4 (ranged from 1 to 8). The mean number of lymph nodes removed by ELD was 16.1 (ranged from 9 to 32). Overall 5-year survivals for SLD in stages I, II and III were 98%, 80% and 38%, respectively. Overall 5-year survivals for ELD in stages I, II and III were 92%, 84% and 40%, respectively.


CONCLUSIONS
There is no significant therapeutic benefit from ELD in patients with RCC receiving radical nephrectomy.
Ou
Y C
YC
Division of Urology, Department of Surgery, Taichung Veterans General Hospital, 160, Sec. 3, Taichung-Kang Road, Taichung 407, Taiwan. ycou@vghtc.vghtc.gov.tw
Ho
H C
HC
Cheng
C L
CL
Ka
Y L
YL
Lin
C H
CH
Yang
C R
CR
D000328:Adult; D000368:Aged; D002292:Carcinoma, Renal Cell / Q000401:mortality / Q000601:surgery*; D005260:Female; D006801:Humans; D007680:Kidney Neoplasms / Q000401:mortality / Q000601:surgery*; D008197:Lymph Node Excision; D008297:Male; D008875:Middle Aged; D009392:Nephrectomy; D015996:Survival Rate