Template-based lymphadenectomy reduces the risk of regional lymph node recurrence among patients with upper/middle ureteral cancer

被引:18
作者
Kondo, Tsunenori [1 ]
Hara, Isao [2 ]
Takagi, Toshio [1 ]
Kodama, Yoshiki [2 ]
Hashimoto, Yasunobu [1 ]
Kobayashi, Hirohito [1 ]
Iizuka, Junpei [1 ]
Omae, Kenji [1 ]
Yoshida, Kazuhiko [1 ]
Tanabe, Kazunari [1 ]
机构
[1] Tokyo Womens Med Univ, Dept Urol, Shinjuku Ku, 8-1 Kawada Cho, Tokyo 1628666, Japan
[2] Wakayama Med Univ, Dept Urol, Wakayama, Japan
关键词
Lymph node excision; Neoplasm recurrence; Survival; Ureter; Urothelial carcinoma; UPPER URINARY-TRACT; TRANSITIONAL-CELL CARCINOMA; UROTHELIAL CARCINOMA; DISSECTION; NEPHROURETERECTOMY; SURVIVAL; IMPACT; METASTASES; MANAGEMENT; EXTENT;
D O I
10.1007/s10147-016-1024-7
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
Background Our previous nonrandomized prospective study showed that template-based lymphadenectomy improved survival among patients with renal pelvic cancer but not among patients with ureteral cancer. However, regional node sites vary according to the tumor's location in relation to the ureter. Therefore, this retrospective study examined the therapeutic role of lymphadenectomy for ureteral cancer according to tumor location. Methods Between January 1988 and September 2015, we performed nephroureterectomy for 154 patients with non-metastatic urothelial carcinoma of the ureter at two Japanese institutions. The tumors' locations were classified as the lower ureter or the upper/middle ureter (before the cranial crossing of the common iliac artery). The appropriate regional nodes were identified based on our previous mapping study. Dissection was classified as complete lymphadenectomy (all regional sites were dissected), incomplete lymphadenectomy (not all sites were dissected), or no lymphadenectomy. We focused the analyses on patients with >= pT2 disease to clarify the effect of the lymphadenectomy. Results Among the 48 patients with upper/middle ureteral cancer, recurrence-free and cancer-specific survival were significantly higher in the complete lymphadenectomy group (vs. the incomplete or no lymphadenectomy groups). However, there were no differences in recurrence-free and cancer-specific survivals among the 56 patients with lower ureteral cancer. In the patients with upper/middle ureteral cancer, multivariate analysis revealed that template-based lymphadenectomy was independently associated with a reduced risk of cancer-specific mortality. Conclusions Template-based lymphadenectomy has a therapeutic benefit for treating patients with upper/middle ureteral cancer but not for treating patients with lower ureteral cancer.
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收藏
页码:145 / 152
页数:8
相关论文
共 20 条
[1]   Role of lymph node dissection in the treatment of urothelial carcinoma of the upper urinary tract: Multi-institutional relapse analysis and immunohistochemical re-evaluation of negative lymph nodes [J].
Abe, T. ;
Shinohara, N. ;
Muranaka, M. ;
Sazawa, A. ;
Maruyama, S. ;
Osawa, T. ;
Harabayashi, T. ;
Kubota, K. ;
Matsuno, Y. ;
Shibata, T. ;
Toyada, Y. ;
Shinno, Y. ;
Minami, K. ;
Sakashita, S. ;
Kumagai, A. ;
Takada, N. ;
Togashi, M. ;
Sano, H. ;
Mori, T. ;
Nonomura, K. .
EJSO, 2010, 36 (11) :1085-1091
[2]  
[Anonymous], GUIDELINES UPPER URI
[3]  
[Anonymous], CAMPBELL WALSH UROLO
[4]   Retroperitoneal lymph node dissection (RPLD) in conjunction with nephroureterectomy in the treatment of infiltrative transitional cell carcinoma (TCC) of the upper urinary tract: Impact on survival [J].
Brausi, Maurizio A. ;
Gavioli, Mirko ;
De Luca, Giuseppe ;
Verrini, Giorgio ;
Peracchia, GianCarlo ;
Simonini, GianLuca ;
Viola, Massimo .
EUROPEAN UROLOGY, 2007, 52 (05) :1414-1420
[5]   No overt influence of lymphadenectomy on cancer-specific survival in organ-confined versus locally advanced upper urinary tract urothelial carcinoma undergoing radical nephroureterectomy: a retrospective international, multi-institutional study [J].
Burger, Maximilian ;
Shariat, Shahrokh F. ;
Fritsche, Hans-Martin ;
Ignacio Martinez-Salamanca, Juan ;
Matsumoto, Kazumasa ;
Chromecki, Thomas F. ;
Ficarra, Vincenzo ;
Kassouf, Wassim ;
Seitz, Christian ;
Pycha, Armin ;
Tritschler, Stefan ;
Walton, Thomas J. ;
Novara, Giacomo .
WORLD JOURNAL OF UROLOGY, 2011, 29 (04) :465-472
[6]   Impact of the extent of regional lymphadenectomy on the survival of patients with urothelial carcinoma of the upper urinary tract [J].
Kondo, Tsunenori ;
Nakazawa, Hayakazu ;
Ito, Fumio ;
Hashimoto, Yasunobu ;
Toma, Hiroshi ;
Tanabe, Kazunari .
JOURNAL OF UROLOGY, 2007, 178 (04) :1212-1217
[7]   Primary site and incidence of lymph node metastases in urothelial carcinoma of upper urinary tract [J].
Kondo, Tsunenori ;
Nakazawa, Hayakazu ;
Ito, Fumio ;
Hashimoto, Yasunobu ;
Toma, Hiroshi ;
Tanabe, Kazunari .
UROLOGY, 2007, 69 (02) :265-269
[8]   Possible Role of Template-based Lymphadenectomy in Reducing the Risk of Regional Node Recurrence after Nephroureterectomy in Patients with Renal Pelvic Cancer [J].
Kondo, Tsunenori ;
Hara, Isao ;
Takagi, Toshio ;
Kodama, Yoshiki ;
Hashimoto, Yasunobu ;
Kobayashi, Hirohito ;
Iizuka, Junpei ;
Omae, Kenji ;
Ikezawa, Eri ;
Yoshida, Kazuhiko ;
Tanabe, Kazunari .
JAPANESE JOURNAL OF CLINICAL ONCOLOGY, 2014, 44 (12) :1233-1238
[9]  
Kondo T, 2014, INT J UROL, V21, P453, DOI [10.1111/iju.12417, 10.1111/iju.12338]
[10]   Role of lymphadenectomy in the management of urothelial carcinoma of the bladder and the upper urinary tract [J].
Kondo, Tsunenori ;
Tanabe, Kazunari .
INTERNATIONAL JOURNAL OF UROLOGY, 2012, 19 (08) :710-721