Current role of lymphadenectomy in the upper tract urothelial carcinoma.

Content Provider	Europe PMC
Author	Alvarez-Maestro, Mario Rivas, Juan Gómez Gregorio, Sergio Alonso y Guerin, Cristina de Castro Gómez, Ángel Tabernero Ledo, Jesús Cisneros
Copyright Year	2016
Abstract	IntroductionLymphadenectomy (LND) has recently attracted considerable interest from urological surgeons, as extended lymphadenectomy might have a role in accurate staging or improving patient survival in those patients with urological malignancies.Upper tract urothelial carcinoma (UTUC) is a relatively rare neoplasm, accounting for about 5% of all urothelial cancers. Up to 30% of patients with muscle-invasive UTUC have metastasis in the regional lymph nodes (LNs), which represents a well-established poor prognostic factor.Material and methodsA medline search was conducted to identify original articles and review articles addressing the role of lymphadenectomy LND in UTUC. Keywords included lymphadenectomy, lymph node excision, nephroureterectomy, and upper tract urothelial carcinoma.ResultsLND instead of lymphadenectomy has recently attracted considerable interest from urological surgeons and might have a potential role in improving the oncological outcome in patients with urothelial carcinoma. LND ideally improves disease staging; thereby, we need to find the way to identify the patients who could really benefit from adjuvant systemic theraphy. Template-based LND with Radical Nephroureterectomy (RNU) for high risk disease is gaining support based on accumulating retrospective data and supports its utility as a potentially therapeutic maneuver. RNU is still the gold standard treatment for UTUC, but minimal invasive procedures such as laparoscopic RNU and Robot Assisted Nephroureterectomy (RANU) are becoming more employed in recent years and should be used by expert hands.ConclusionsTherapeutic benefits of LND and nodal status on disease free survival (DFS) and Cancer Free Survival (CSS) remains controversial. Although most of the data comes from retrospective studies, we encourage performing well designed, prospective, and multicentre studies to clarify this in the coming years.
ISSN	20804806
Journal	Central European Journal of Urology
Volume Number	69
PubMed Central reference number	PMC5260448
Issue Number	4
PubMed reference number	28127455
e-ISSN	20804873
DOI	10.5173/ceju.2016.834
Language	English
Publisher	Polish Urological Association
Publisher Date	2016-11-30
Access Restriction	Open
Rights License	This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International (CC BY-NC-SA 4.0) License, allowing third parties to copy and redistribute the material in any medium or format and to remix, transform, and build upon the material, provided the original work is properly cited and states its license. Copyright by Polish Urological Association
Subject Keyword	upper tract urothelial carcinoma lymphadenectomy nephroureterectomy overall survival
Content Type	Text
Resource Type	Article
Subject	Urology