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FältnamnIndikatorerMetadata
00003761naa a2200409 4500
001oai:gup.ub.gu.se/252846
003SwePub
008240910s2017 | |||||||||||000 ||eng|
0247 a https://gup.ub.gu.se/publication/2528462 URI
0247 a https://doi.org/10.1016/j.urolonc.2016.11.0022 DOI
040 a (SwePub)gu
041 a eng
042 9 SwePub
072 7a ref2 swepub-contenttype
072 7a art2 swepub-publicationtype
1001 a Winer, Andrew G4 aut
2451 0a Prognostic value of lymph node yield during nephroureterectomy for upper tract urothelial carcinoma.
264 1b Elsevier BV,c 2017
520 a Lymph node dissection (LND) performed during radical nephroureterectomy (RNU) for upper tract urothelial carcinoma (UTUC) remains controversial and difficult to evaluate. The aim of this study was to investigate whether removal of more lymph nodes during RNU is safe and improves oncologic outcomes.We evaluated 422 patients who underwent RNU with concomitant LND for upper tract urothelial carcinoma between 1976 and 2015, assessing for an association between total nodes removed, recurrence-free survival, and cancer-specific survival using Cox proportional hazards models. We also investigated the relationship between nodal yield and perioperative metrics and intersurgeon variability using linear regression.In our cohort of 442 patients, 239 developed recurrences and 94 patients died of disease. Median follow-up among survivors was 3.7 years (interquartile range: 1.2, 7.4). The median nodal yield was 9 (interquartile range: 4, 16). Among patients with node-positive disease (pN1), we observed a significant improvement in recurrence-free survival (hazard ratio = 0.84 per 5 nodes removed, P = 0.039) and a nonsignificant improvement in cancer-specific survival with an increase in the nodal yield (hazard ratio = 0.90 per 5 nodes removed, P = 0.2). There was no evidence of an association between node yield and operative time, estimated blood loss, or 30-day complications on multivariable analysis. There was significant heterogeneity among surgeons regarding the extent of LND (P<0.0001).We found that a more extensive node dissection may improve oncologic outcomes in a subset of high-risk patients without significantly increasing operative time or serious complications. Additionally, we identified considerable intersurgeon heterogeneity regarding the extent of LND furthering the notion of surgeon variability as a nonstandardized factor.
650 7a MEDICIN OCH HÄLSOVETENSKAPx Klinisk medicinx Urologi och njurmedicin0 (SwePub)302142 hsv//swe
650 7a MEDICAL AND HEALTH SCIENCESx Clinical Medicinex Urology and Nephrology0 (SwePub)302142 hsv//eng
7001 a Vertosick, Emily A4 aut
7001 a Ghanaat, Mazyar4 aut
7001 a Corradi, Renato B4 aut
7001 a Carlsson, Sigrid,d 1982u Gothenburg University,Göteborgs universitet,Institutionen för kliniska vetenskaper, Avdelningen för urologi,Institute of Clinical Sciences, Department of Urology4 aut0 (Swepub:gu)xcasig
7001 a Sjoberg, Daniel D4 aut
7001 a Sankin, Alexander I4 aut
7001 a Sfakianos, John P4 aut
7001 a Cha, Eugene K4 aut
7001 a Dalbagni, Guido4 aut
7001 a Coleman, Jonathan A4 aut
7102 a Göteborgs universitetb Institutionen för kliniska vetenskaper, Avdelningen för urologi4 org
7730 t Urologic oncologyd : Elsevier BVg 35:4q 35:4x 1873-2496
7730 t Urologic Oncology: Seminars and Original Investigationsd : Elsevier BVg 35:4q 35:4x 1078-1439
8564 u https://europepmc.org/articles/pmc5502780?pdf=render
8564 8u https://gup.ub.gu.se/publication/252846
8564 8u https://doi.org/10.1016/j.urolonc.2016.11.002

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