To evaluate the role of side and location of the primary renal cell carcinoma (RCC) on the risk of lymph node invasion (LNI) and/or nodal progression (NP) during follow-up.
We evaluated 2485 patients with unilateral RCC, surgically treated in a single tertiary care referral center. Outcomes were LNI at surgery and/or NP during follow-up. We studied if RCC side (left vs. right) and location (upper vs. middle vs. hilar vs. lower area vs. more than one area) affected the probability of LNI and/or NP at follow-up.
Overall, 43 and 15% of patients underwent lymph node dissection and had LNI at surgery, respectively. During follow-up, 2.2% of patients had NP. Higher rates of LNI and NP were observed for patients with primary tumor located in more than one anatomical kidney area relative to patients with tumor in a single area (upper 11% vs. middle 10% vs. hilar 0%, vs. lower 12% vs. more than one area 26%, p < 0.01). cM1, cN1, pT2/pT3/pT4 disease and Fuhrman grade 3/4 were independent predictors of the study outcome (all p ≤ 0.01). Neither the RCC side nor the location reached the independent predictor status (all p > 0.1).
Patients with single-side and more than one anatomical kidney area affected by RCC have higher rate of LNI at surgery and/or NP at follow-up. Neither side nor location of primary RCC tumor is related to the risk of harboring LNI at surgery and/or developing NP at follow-up.
World journal of urology. 2018 Nov 24 [Epub ahead of print]
Alessandro Nini, Alessandro Larcher, Walter Cazzaniga, Paolo Dell'Oglio, Francesco Cianflone, Fabio Muttin, Francesco Ripa, Andrea Salonia, Alberto Briganti, Francesco Montorsi, Roberto Bertini, Umberto Capitanio
Unit of Urology, University Vita-Salute San Raffaele, IRCCS San Raffaele Scientific Institute, Via Olgettina 60, 20132, Milan, Italy., Unit of Urology, University Vita-Salute San Raffaele, IRCCS San Raffaele Scientific Institute, Via Olgettina 60, 20132, Milan, Italy. .