Lymphadenectomy for Upper Tract Urothelial Carcinoma: A Systematic Review.

The role of lymphonodal dissection during surgery for a tumor of the urinary tract remains controversial.

To analyze anatomical bases of lymphonodal dissection in tumors of the upper urinary tract and analyze its impact on survival, recurrence, and staging. Acquisition of data: A web-based search for scientific articles using Medline/Pubmed was carried out to identify and analyze articles on the practice and the role of lymphonodal dissection in this indication.

The lymphatic drainage of the upper urinary tract has rarely been studied and is poorly understood. The lymphonodal metastatic extension is the most common extension in upper urinary tract urothelial carcinoma. Lymphnode invasion is a clear independent poor prognostic factor. Therefore, it seems legitimate to offer an extended lymphonodal dissection to patients undergoing surgery to cure these tumors. When lymphnodes dissection respects clear anatomical principles based on the location of the primary tumor and its extension, it improves both survival and recurrence rates. This result could be secondary to the treatment of subclinical metastatic disease.

An extended lymphadenectomy during surgery for upper urinary tract urothelial carcinoma following strict anatomical pattern improves staging with a highly probable therapeutic benefit.

Journal of clinical medicine. 2019 Aug 08*** epublish ***

Igor Duquesne, Idir Ouzaid, Yohann Loriot, Marco Moschini, Evanguelos Xylinas

Department of Urology, Cochin Hospital, Assistance Publique-Hôpitaux de Paris, Paris Descartes University, 75014 Paris, France., Department of Urology, Bichat-Claude Bernard Hospital, Assistance Publique-Hôpitaux de Paris, Paris Diderot University, 75018 Paris, France., Department of Cancer Medicine, Gustave Roussy Institute, Cancer Campus, Grand Paris, University of Paris-Sud, 94800 Villejuif, France., Klinik für Urologie, Luzerner Kantonsspital, 6004 Lucerne, Switzerland., Department of Urology, Bichat-Claude Bernard Hospital, Assistance Publique-Hôpitaux de Paris, Paris Descartes University, 75006 Paris, France. .

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