• Je něco špatně v tomto záznamu ?

Need for and extent of lymph node dissection for upper tract urothelial carcinoma: an updated review in 2023

T. Yanagisawa, T. Kawada, M. von Deimling, E. Laukhtina, T. Kimura, SF. Shariat

. 2023 ; 33 (4) : 258-268. [pub] 20230403

Jazyk angličtina Země Spojené státy americké

Typ dokumentu přehledy, časopisecké články

Perzistentní odkaz   https://www.medvik.cz/link/bmc23010937

PURPOSE OF REVIEW: Although lymph node dissection (LND) during radical nephroureterectomy (RNU) is recommended for high-risk nonmetastatic upper tract urothelial carcinoma (UTUC), adherence to guidelines remains insufficient in clinical practice. Therefore, this review aims to comprehensively summarize the current evidence regarding the diagnostic, prognostic, and therapeutic impact of LND during RNU in UTUC patients. RECENT FINDINGS: Clinical nodal staging using conventional CT scan has low sensitivity (25%) and diagnostic accuracy [area under the curve (AUC): 0.58] in UTUC, suggesting the importance of LND for obtaining accurate N-staging. Patients with pathological node-positive (pN+) disease have poor disease-free survival (DFS), cancer-specific survival (CSS), and overall survival (OS) compared with those with pN0. In addition, population-based studies showed that patients who underwent LND improved CSS and OS than those who did not, even in patients who received adjuvant systemic therapy. The number of lymph nodes removed has also been shown to be associated with improved CSS and OS, even in pT0 patients. Template-based LND should be performed as the extent of lymph node is more important than the number of lymph nodes. Robot-assisted RNU may facilitate performing a meticulous LND compared with a laparoscopic approach. Postoperative complications such as lymphatic and/or chylous leakage are increased but adequately manageable. However, the current evidence is not supported by high-quality studies. SUMMARY: Based on the published data, LND during RNU is a standard procedure for high-risk nonmetastatic UTUC, owing to its diagnostic, staging, prognostic, and, potentially, therapeutic benefits. Template-based LND should be offered to all patients who are planned for RNU for high-risk nonmetastatic UTUC. Patients with pN+ disease are optimal candidates for adjuvant systemic therapy. Robot-assisted RNU may facilitate meticulous LND compared with laparoscopic RNU.

Citace poskytuje Crossref.org

000      
00000naa a2200000 a 4500
001      
bmc23010937
003      
CZ-PrNML
005      
20230801132714.0
007      
ta
008      
230718s2023 xxu f 000 0|eng||
009      
AR
024    7_
$a 10.1097/MOU.0000000000001097 $2 doi
035    __
$a (PubMed)37014743
040    __
$a ABA008 $b cze $d ABA008 $e AACR2
041    0_
$a eng
044    __
$a xxu
100    1_
$a Yanagisawa, Takafumi $u Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria $u Department of Urology, The Jikei University School of Medicine, Tokyo
245    10
$a Need for and extent of lymph node dissection for upper tract urothelial carcinoma: an updated review in 2023 / $c T. Yanagisawa, T. Kawada, M. von Deimling, E. Laukhtina, T. Kimura, SF. Shariat
520    9_
$a PURPOSE OF REVIEW: Although lymph node dissection (LND) during radical nephroureterectomy (RNU) is recommended for high-risk nonmetastatic upper tract urothelial carcinoma (UTUC), adherence to guidelines remains insufficient in clinical practice. Therefore, this review aims to comprehensively summarize the current evidence regarding the diagnostic, prognostic, and therapeutic impact of LND during RNU in UTUC patients. RECENT FINDINGS: Clinical nodal staging using conventional CT scan has low sensitivity (25%) and diagnostic accuracy [area under the curve (AUC): 0.58] in UTUC, suggesting the importance of LND for obtaining accurate N-staging. Patients with pathological node-positive (pN+) disease have poor disease-free survival (DFS), cancer-specific survival (CSS), and overall survival (OS) compared with those with pN0. In addition, population-based studies showed that patients who underwent LND improved CSS and OS than those who did not, even in patients who received adjuvant systemic therapy. The number of lymph nodes removed has also been shown to be associated with improved CSS and OS, even in pT0 patients. Template-based LND should be performed as the extent of lymph node is more important than the number of lymph nodes. Robot-assisted RNU may facilitate performing a meticulous LND compared with a laparoscopic approach. Postoperative complications such as lymphatic and/or chylous leakage are increased but adequately manageable. However, the current evidence is not supported by high-quality studies. SUMMARY: Based on the published data, LND during RNU is a standard procedure for high-risk nonmetastatic UTUC, owing to its diagnostic, staging, prognostic, and, potentially, therapeutic benefits. Template-based LND should be offered to all patients who are planned for RNU for high-risk nonmetastatic UTUC. Patients with pN+ disease are optimal candidates for adjuvant systemic therapy. Robot-assisted RNU may facilitate meticulous LND compared with laparoscopic RNU.
650    _2
$a lidé $7 D006801
650    12
$a karcinom z přechodných buněk $x patologie $7 D002295
650    12
$a nádory močového měchýře $x patologie $7 D001749
650    _2
$a lymfadenektomie $x škodlivé účinky $x metody $7 D008197
650    _2
$a lymfatické uzliny $x diagnostické zobrazování $x chirurgie $x patologie $7 D008198
650    _2
$a nefroureterektomie $x metody $7 D000074682
650    _2
$a retrospektivní studie $7 D012189
650    12
$a nádory močovodu $x chirurgie $7 D014516
655    _2
$a přehledy $7 D016454
655    _2
$a časopisecké články $7 D016428
700    1_
$a Kawada, Tatsushi $u Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria $u Department of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
700    1_
$a von Deimling, Markus $u Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria $u Department of Urology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
700    1_
$a Laukhtina, Ekaterina $u Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria $u Institute for Urology and Reproductive Health, Sechenov University, Moscow, Russia
700    1_
$a Kimura, Takahiro $u Department of Urology, The Jikei University School of Medicine, Tokyo
700    1_
$a Shariat, Shahrokh F $u Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria $u Division of Urology, Department of Special Surgery, The University of Jordan, Amman, Jordan $u Department of Urology, University of Texas Southwestern Medical Center, Dallas, Texas, USA $u Department of Urology, Second Faculty of Medicine, Charles University, Prague, Czech Republic $u Department of Urology, Weill Cornell Medical College, New York, New York, USA $u Karl Landsteiner Institute of Urology and Andrology, Vienna, Austria
773    0_
$w MED00001296 $t Current opinion in urology $x 1473-6586 $g Roč. 33, č. 4 (2023), s. 258-268
856    41
$u https://pubmed.ncbi.nlm.nih.gov/37014743 $y Pubmed
910    __
$a ABA008 $b sig $c sign $y p $z 0
990    __
$a 20230718 $b ABA008
991    __
$a 20230801132711 $b ABA008
999    __
$a ok $b bmc $g 1963385 $s 1197202
BAS    __
$a 3
BAS    __
$a PreBMC-MEDLINE
BMC    __
$a 2023 $b 33 $c 4 $d 258-268 $e 20230403 $i 1473-6586 $m Current opinion in urology $n Curr Opin Urol $x MED00001296
LZP    __
$a Pubmed-20230718
Zpět

Najít záznam

Citační ukazatele

Pouze přihlášení uživatelé

Možnosti archivace