Role of lymph node dissection in renal cell cancer

Urol Oncol. 2019 Mar;37(3):187-192. doi: 10.1016/j.urolonc.2018.03.006. Epub 2018 Mar 27.

Abstract

Lymph node metastasis in renal cell cancer (RCC) portends an extremely poor prognosis. Despite proven staging benefit, the therapeutic value of lymph node dissection in RCC remains questionable. The only prospective randomized trial examining its role failed to show any benefit. However, subsequent retrospective publications have attempted to identify high-risk cohorts and clinical scenarios where removal of nodes may improve survival. The aim of this article is to provide a comprehensive review looking at the role of lymph node dissection in RCC if any, the ideal extent of dissection, and also tools a clinician could employ to identify those who would most likely benefit from this exercise.

Keywords: Lymph node dissection; Renal cell cancer; biomarkers; complications; prognosis; survival.

Publication types

  • Review

MeSH terms

  • Carcinoma, Renal Cell / mortality
  • Carcinoma, Renal Cell / pathology
  • Carcinoma, Renal Cell / surgery*
  • Humans
  • Kidney Neoplasms / mortality
  • Kidney Neoplasms / pathology
  • Kidney Neoplasms / surgery*
  • Lymph Node Excision / adverse effects
  • Lymph Node Excision / methods*
  • Lymph Nodes / pathology
  • Lymph Nodes / surgery
  • Lymphatic Metastasis / pathology
  • Neoplasm Recurrence, Local / mortality
  • Neoplasm Recurrence, Local / pathology
  • Neoplasm Recurrence, Local / surgery*
  • Neoplasm Staging
  • Nephrectomy / adverse effects
  • Nephrectomy / methods*
  • Patient Selection
  • Prognosis
  • Retroperitoneal Space
  • Treatment Outcome