title: Contemporary role of lymph node dissection at the time of radical nephroureterectomy for upper tract urothelial carcinoma.
abstract: OBJECTIVE
  To review the contemporary data on the role of lymph node dissection (LND) at the time of radical nephroureterectomy (RNU) for upper tract urothelial carcinoma (UTUC).
  
  
  METHODS
  A computerized bibliographic search using the following protocol ("Nephroureterectomy") AND ("Lymphadenectomy" OR "Lymph node" OR "Lymphatic") was performed in MEDLINE to identify all original and review articles that addressed the role of LND for UTUC.
  
  
  RESULTS
  Regional lymph node (LN) boundaries of UTUC have been recently investigated in mapping studies to propose anatomic templates of LND according to the laterality and location of primary tumor. Although these anatomic templates remained poorly described, most reports supported the staging benefit of LND that allowed for risk stratification of patients with (pN+) or without (pN0) LN metastases from those who did not undergo such a procedure (pNx). In addition, the therapeutic benefit of LND at the time of RNU was supported by better oncological outcomes obtained after complete LND when compared to incomplete or no LND, especially in the group of patients with advanced disease. The number of LNs removed was also correlated with both, more accurate staging and greater cancer-specific survival after LND, whose feasibility and safety have been validated in prospective studies.
  
  
  CONCLUSIONS
  Despite mostly based on data with level of evidence 3, our comprehensive review of the literature supports the staging and therapeutic benefits of LND at the time of RNU for UTUC, which are particularly significant for patients with muscle-invasive or locally advanced disease.
authors.affiliation: Academic Department of Urology, Pitié-Salpêtrière Hospital, APHP, 47-83 boulevard de l'hopital, 75013, Paris, France.|GRC - UPMC n° 5, ONCOTYPE-URO, Institut Universitaire de Cancérologie, UPMC University Paris 6, 75005, Paris, France.
authors.forename: Thomas
authors.initials: T
authors.lastname: Seisen
authors.affiliation: Academic Department of Urology and Comprehensive Cancer Center, Vienna General Hospital, Vienna, Austria.
authors.forename: Shahrokh F
authors.initials: SF
authors.lastname: Shariat
authors.affiliation: GRC - UPMC n° 5, ONCOTYPE-URO, Institut Universitaire de Cancérologie, UPMC University Paris 6, 75005, Paris, France.|Academic Department of Urology, Tenon Hospital, APHP, 75020, Paris, France.
authors.forename: Olivier
authors.initials: O
authors.lastname: Cussenot
authors.affiliation: Academic Department of Urology, CHU Rennes and University of Rennes, Rennes, France.
authors.forename: Benoit
authors.initials: B
authors.lastname: Peyronnet
authors.affiliation: Academic Department of Radiology, Pitié Salpêtrière Hospital, APHP, 75013, Paris, France.
authors.forename: Raphaële
authors.initials: R
authors.lastname: Renard-Penna
authors.affiliation: Department of Urology, La Louvière Private Hospital, Lille, France.
authors.forename: Pierre
authors.initials: P
authors.lastname: Colin
authors.affiliation: Academic Department of Urology, Pitié-Salpêtrière Hospital, APHP, 47-83 boulevard de l'hopital, 75013, Paris, France. morgan.roupret@psl.aphp.fr.|GRC - UPMC n° 5, ONCOTYPE-URO, Institut Universitaire de Cancérologie, UPMC University Paris 6, 75005, Paris, France. morgan.roupret@psl.aphp.fr.
authors.forename: Morgan
authors.initials: M
authors.lastname: Rouprêt
mesh_terms: D002295:Carcinoma, Transitional Cell / Q000473:pathology / Q000601:surgery*; D006801:Humans; D007680:Kidney Neoplasms / Q000473:pathology / Q000601:surgery*; D008197:Lymph Node Excision / Q000379:methods*; D008198:Lymph Nodes / Q000473:pathology; D009392:Nephrectomy / Q000379:methods*; D015996:Survival Rate; D014513:Ureter / Q000601:surgery*; D014516:Ureteral Neoplasms / Q000473:pathology / Q000601:surgery*; D013520:Urologic Surgical Procedures / Q000379:methods
keywords: Lymph node excision; Ureter; Ureteral neoplasm; Urinary tract; Urothelial carcinoma
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