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Outcome after resec...
Outcome after resection of occult and non-occult lymph node metastases at the time of nephrectomy
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- Kuusk, Teele (författare)
- Department of Urology, Darent Valley Hospital, Dartford and Gravesham NHS Trust, Dartford, United Kingdom; Department of Urology, Renal Cancer Unit, Royal Free Hospital, London, United Kingdom
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- Klatte, Tobias (författare)
- Department of Surgery, University of Cambridge, Cambridge, United Kingdom; Department of Urology, Royal Bournemouth Hospital, Bournemouth, United Kingdom
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- Zondervan, Patricia (författare)
- Department of Urology, Academic Medical Center, Amsterdam, Netherlands
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- Lagerveld, Brunolf (författare)
- Department of Urology, OLVG, Amsterdam, Netherlands
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- Graafland, Niels (författare)
- Department of Urology, Netherlands Cancer Institute, Amsterdam, Netherlands
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- Hendricksen, Kees (författare)
- Department of Urology, Netherlands Cancer Institute, Amsterdam, Netherlands
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- Capitanio, Umberto (författare)
- Department of Urology, Vita-Salute San Raffaele University, IRCCS San Raffaele Scientific Institute, Milan, Italy
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- Minervini, Andrea (författare)
- Department of Urology, Careggi Hospital, University of Florence, Florence, Italy
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- Stewart, Grant D. (författare)
- Department of Surgery, University of Cambridge, Cambridge, United Kingdom
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- Ljungberg, Börje, Professor, 1949- (författare)
- Umeå universitet,Urologi och andrologi
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- Horenblas, Simon (författare)
- Department of Urology, Netherlands Cancer Institute, Amsterdam, Netherlands
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- Bex, Axel (författare)
- Department of Urology, Renal Cancer Unit, Royal Free Hospital, London, United Kingdom; Department of Urology, Netherlands Cancer Institute, Amsterdam, Netherlands
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(creator_code:org_t)
- 2021-02-25
- 2021
- Engelska.
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Ingår i: World journal of urology. - : Springer Nature. - 0724-4983 .- 1433-8726. ; 39:9, s. 3377-3383
- Relaterad länk:
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https://urn.kb.se/re...
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https://doi.org/10.1...
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Abstract
Ämnesord
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- Purpose: There is sparse evidence on outcomes of resected occult LN metastases at the time of nephrectomy (synchronous disease). We sought to analyse a large international cohort of patients and to identify clinico-pathological predictors of long-term survival.Materials and methods: We collected data of consecutive patients who underwent nephrectomy and LND for Tany cN0-1pN1 and cM0-1 RCC at 7 referral centres between 1988 and 2019. Patients were stratified into four clinico-pathological groups: (1) cN0cM0-pN1, (2) cN1cM0-pN1(limited, 1–3 positive nodes), (3) cN1cM0-pN1(extensive, > 3 positive nodes), and (4) cM1-pN1. Overall survival (OS) was estimated using the Kaplan–Meier method, and associations with all-cause mortality (ACM) were evaluated using Cox models with multiple imputations.Results: Of the 4370 patients with LND, 292 patients with pN1 disease were analysed. Median follow-up was 62 months, during which 171 patients died. Median OS was 21 months (95% CI 17–30 months) and the 5-year OS rate was 24% (95% CI 18–31%). Patients with cN0cM0-pN1 disease had a median OS of 57 months and a 5-year OS rate of 43%. 5-year OS (median OS) decreased to 29% (33 months) in cN1cM0-pN1(limited) and to 23% (23 months) in cN1cM0-pN1(extensive) patients. Those with cM1-pN1 disease had the worst prognosis, with a 5-year OS rate of 13% (9 months). On multivariable analysis, age (p = 0.034), tumour size (p = 0.02), grade (p = 0.02) and clinico-pathological group (p < 0.05) were significant predictors of ACM.Conclusion: Depending on clinico-pathological group, grade and tumour size, 5-year survival of patients with LN metastases varies from 13 to 43%. Patients with resected occult lymph node involvement (cN0/pN1 cM0) have the best prognosis with a considerable chance of long-term survival.
Ämnesord
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Urologi och njurmedicin (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Urology and Nephrology (hsv//eng)
Nyckelord
- Lymph node
- Lymph node dissection
- Occult lymph node
- Overall survival
- Renal cell carcinoma
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Kuusk, Teele
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Klatte, Tobias
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Zondervan, Patri ...
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Lagerveld, Bruno ...
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Graafland, Niels
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Hendricksen, Kee ...
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Capitanio, Umber ...
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Minervini, Andre ...
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Stewart, Grant D ...
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Ljungberg, Börje ...
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Horenblas, Simon
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Bex, Axel
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