EAU 2017: Lymph node dissection is not associated with increased 30-day complication among patients undergoing radical nephrectomy for renal cell carcinoma: a propensity-score based analysis

London, England (UroToday.com) The role of lymph node dissection (LND) at the time of radical nephrectomy (RN) is controversial because its oncologic benefit is unclear. Notably, there is little information on complication rates associated with LND to inform clinical risk-benefit analyses. The objective of Dr. Gershman’s work was to evaluate the association of LND with 30-day complications among patients undergoing RN for renal cell carcinoma (RCC).

The study design was a retrospective institutional cohort analysis of 2,006 patients who underwent RN for M0 or M1 RCC between 1990 and 2010. Seven hundred seventy-four patients underwent LND. Propensity-score (PS) techniques were used to adjust for possible confounding factors including at the individual surgeon level.

Thirty day complications occurred in 194 (9%) of patients. Major compications (Clavien 3-5) occurred in 81 (4%) patients. Patients selected for LND had more aggressive and advanced disease; however, clinicopathologic features were well-adjusted after PS techniques. LND was not associated with an increased risk of any complication or major complication. After adjustment, no differences in complication rates were seen in pN0 versus pN1 patients. Furthermore, greater extent of LND (removal of 13 or more nodes) was not associated with 30-day complication rates.

Dr. Gershman and colleagues concluded that performance of LND at the time of RN was not an independently associated with an increased risk of 30-day complications. This information is helpful when discussing the role of LND in association with RN for patients with cM0 or cM1 RCC.

Speaker(s): B. Gershman, Providence, RI

Written By: Benjamin T. Ristau, MD, SUO Fellow, Fox Chase Cancer Center, Philadelphia, PA.

at the #EAU17 - March 24-28, 2017- London, England
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