Trends of lymphadenectomy in upper tract urothelial carcinoma (UTUC) patients treated with radical nephroureterectomy View Full Text


Ontology type: schema:ScholarlyArticle     


Article Info

DATE

2017-10

AUTHORS

Marco Moschini, Beat Foerster, Mohammad Abufaraj, Francesco Soria, Thomas Seisen, Morgan Roupret, Pierre Colin, Alexandre De la Taille, Benoit Peyronnet, Karim Bensalah, Roman Herout, Manfred Peter Wirth, Vladimir Novotny, Piotr Chlosta, Marco Bandini, Francesco Montorsi, Giuseppe Simone, Michele Gallucci, Giuseppe Romeo, Kazumasa Matsumoto, Pierre Karakiewicz, Alberto Briganti, Shahrokh F. Shariat

ABSTRACT

INTRODUCTION: To evaluate temporal trends in the delivery and extent of lymphadenectomy (LND) in radical nephroureterectomy (RNU) performed in upper tract urothelial carcinoma (UTUC) patients. METHODS: We evaluated a multi institutional collaborative database composed by 1512 consecutive patients diagnosed with UTUC treated with RNU between 1990 and 2016. Year of surgery were grouped in five periods: 1990-1996, 1997-2002, 2003-2007, 2008-2012 and 2013-2016. Data about LND were available for all patients and numbers of nodes removed and positive were reported by dedicate uropathologists. The Mann-Whitney and Chi square tests were used to compare the statistical significance of differences in medians and proportions, respectively. RESULTS: Five hundred forty-five patients (36.0%) received a concomitant LND while 967 (64.0%) did not; 41.9% of open RNU patients received a concomitant LND compared to 24.4% of laparoscopic RNU patients. The rate of concomitant LND increased with time in the overall, laparoscopic and open RNU patients (all p < 0.03). Patients treated with open RNU also had an increasing likelihood to receive an adequate concomitant LND (p < 0.001) while those undergoing a laparoscopic approach did not (p = 0.1). Patients treated with concomitant LND had a median longer operative time of 20 min (p = 0.01). There were no differences in perioperative outcomes and complications between patients who received a concomitant LND and those who did not (p > 0.1). CONCLUSION: Although an increased trend was observed, most patients treated with RNU did not receive LND. Surgeons using a laparoscopic RNU were less likely to perform a concomitant LND, and when done, they remove less nodes. More... »

PAGES

1541-1547

References to SciGraph publications

Identifiers

URI

http://scigraph.springernature.com/pub.10.1007/s00345-017-2026-4

DOI

http://dx.doi.org/10.1007/s00345-017-2026-4

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1084020990

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/28247066


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