Lymphadenectomy for Upper Tract Urothelial Carcinoma: A Systematic Review.
lymphadenectomy
outcomes
recurrence
renal pelvis
survival
upper tract
ureter
urothelial carcinoma
Journal
Journal of clinical medicine
ISSN: 2077-0383
Titre abrégé: J Clin Med
Pays: Switzerland
ID NLM: 101606588
Informations de publication
Date de publication:
08 Aug 2019
08 Aug 2019
Historique:
received:
25
06
2019
revised:
15
07
2019
accepted:
05
08
2019
entrez:
11
8
2019
pubmed:
11
8
2019
medline:
11
8
2019
Statut:
epublish
Résumé
The role of lymphonodal dissection during surgery for a tumor of the urinary tract remains controversial. To analyze anatomical bases of lymphonodal dissection in tumors of the upper urinary tract and analyze its impact on survival, recurrence, and staging. Acquisition of data: A web-based search for scientific articles using Medline/Pubmed was carried out to identify and analyze articles on the practice and the role of lymphonodal dissection in this indication. The lymphatic drainage of the upper urinary tract has rarely been studied and is poorly understood. The lymphonodal metastatic extension is the most common extension in upper urinary tract urothelial carcinoma. Lymphnode invasion is a clear independent poor prognostic factor. Therefore, it seems legitimate to offer an extended lymphonodal dissection to patients undergoing surgery to cure these tumors. When lymphnodes dissection respects clear anatomical principles based on the location of the primary tumor and its extension, it improves both survival and recurrence rates. This result could be secondary to the treatment of subclinical metastatic disease. An extended lymphadenectomy during surgery for upper urinary tract urothelial carcinoma following strict anatomical pattern improves staging with a highly probable therapeutic benefit.
Sections du résumé
BACKGROUND
BACKGROUND
The role of lymphonodal dissection during surgery for a tumor of the urinary tract remains controversial.
OBJECTIVE
OBJECTIVE
To analyze anatomical bases of lymphonodal dissection in tumors of the upper urinary tract and analyze its impact on survival, recurrence, and staging. Acquisition of data: A web-based search for scientific articles using Medline/Pubmed was carried out to identify and analyze articles on the practice and the role of lymphonodal dissection in this indication.
DATA SYNTHESIS
RESULTS
The lymphatic drainage of the upper urinary tract has rarely been studied and is poorly understood. The lymphonodal metastatic extension is the most common extension in upper urinary tract urothelial carcinoma. Lymphnode invasion is a clear independent poor prognostic factor. Therefore, it seems legitimate to offer an extended lymphonodal dissection to patients undergoing surgery to cure these tumors. When lymphnodes dissection respects clear anatomical principles based on the location of the primary tumor and its extension, it improves both survival and recurrence rates. This result could be secondary to the treatment of subclinical metastatic disease.
CONCLUSION
CONCLUSIONS
An extended lymphadenectomy during surgery for upper urinary tract urothelial carcinoma following strict anatomical pattern improves staging with a highly probable therapeutic benefit.
Identifiants
pubmed: 31398895
pii: jcm8081190
doi: 10.3390/jcm8081190
pmc: PMC6722659
pii:
doi:
Types de publication
Journal Article
Review
Langues
eng
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