title: Effect of lymph node dissection on the outcomes of upper tract urothelial carcinomas: a meta-analysis.
abstract: A systematic search was conducted in PubMed, Cochrane Library. 6032 patients were included. There was no significant difference in survival between LND and NLND (non-lymph node dissection) among the patients. However, the patients in the LND group had more advanced tumour stages and grades (p < 0.001). In addition, among the muscle-invasive patients, LND demonstrated remarkable CSS improvement compared with NLND (HR: 2.19; 95% CI: 1.26-3.80; p = 0.005). Moreover, subgroup analyses found that patients with muscle-invasive UTUC had better CSS (HR: 1.22; 95% CI: 1.02-1.45; p < 0.001) than those patients with pN0 compared to pNx (NLND). In terms of RFS, the results showed no difference in the survival rates between pN0 and pNx patients in the subgroup of patients with muscle-invasive UTUC (HR: 1.40; 95% CI: 0.84-2.23; p = 0.19). Our meta-analysis supports that LND may prolong the CSS and RFS of UTUC, especially for patients with muscle-invasive UTUC.
authors.affiliation: Department of Urology, First Affiliated Hospital of Dalian Medical University , 222 Zhong Shan Road, Dalian, Liaoning 116011 , P.R. China.
authors.forename: Deyong
authors.initials: D
authors.lastname: Yang
authors.forename: Qiwei
authors.initials: Q
authors.lastname: Chen
authors.forename: Xishuang
authors.initials: X
authors.lastname: Song
authors.forename: Jianbo
authors.initials: J
authors.lastname: Wang
authors.forename: Xiangyu
authors.initials: X
authors.lastname: Che
authors.forename: Zheng
authors.initials: Z
authors.lastname: Zhu
authors.forename: Wei
authors.initials: W
authors.lastname: Zheng
authors.forename: Lina
authors.initials: L
authors.lastname: Wang
mesh_terms: D002295:Carcinoma, Transitional Cell / Q000401:mortality / Q000556:secondary* / Q000601:surgery; D018572:Disease-Free Survival; D006801:Humans; D007680:Kidney Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D008197:Lymph Node Excision; D009130:Muscle, Smooth / Q000473:pathology; D009361:Neoplasm Invasiveness; D009392:Nephrectomy; D016019:Survival Analysis; D016896:Treatment Outcome; D014513:Ureter / Q000601:surgery; D014516:Ureteral Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*
keywords: lymph node dissection; radical nephroureterectomy; recurrence; survival; urinary tract cancer; urothelial carcinoma