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Trends of lymphadenectomy in upper tract urothelial carcinoma (UTUC) patients treated with radical nephroureterectomy.
- Source :
-
World Journal of Urology . Oct2017, Vol. 35 Issue 10, p1541-1547. 7p. - Publication Year :
- 2017
-
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. [ABSTRACT FROM AUTHOR]
Details
- Language :
- English
- ISSN :
- 07244983
- Volume :
- 35
- Issue :
- 10
- Database :
- Academic Search Index
- Journal :
- World Journal of Urology
- Publication Type :
- Academic Journal
- Accession number :
- 125326057
- Full Text :
- https://doi.org/10.1007/s00345-017-2026-4