ArticleThe Journal of urology2018
Retroperitoneal Lymphadenectomy for High Risk, Nonmetastatic Renal Cell Carcinoma: An Analysis of the ASSURE (ECOG-ACRIN 2805) Adjuvant Trial.
Article in The Journal of urology, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers.
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Who cites it
19 citing papers in PubMed, 50 citations in OpenAlex.
- Distant metastasis prediction in renal carcinoma: a retrospective cohort study using interpretable machine learning.Translational andrology and urology · 2026Article
- Determining the Impact of Histology on the Incidence, Pattern, and Timing of Recurrences in Patients with Renal Cell Carcinoma: A Pooled Analysis from the SORCE and ASSURE Trials.European urology open science · 2025Article
- The Current Role of Lymph Node Dissection in Nonmetastatic Localized Renal Cell Carcinoma.Journal of clinical medicine · 2023Review
- Predictive factors of recurrence after surgery in patients with non-metastatic renal cell carcinoma with venous tumor thrombus (UroCCR-56 Study).World journal of urology · 2023Article
- Potential benefit of lymph node dissection during radical nephrectomy for kidney cancer: A review and critical analysis of current literature.Asian journal of urology · 2022Review
- Retroperitoneal castleman disease mimicking lymph node spread from clear renal cell carcinoma. A case report.Urology case reports · 2021Article
- The Role of Lymph Node Dissection for Non-Metastatic Renal Cell Carcinoma: An Updated Systematic Review and Meta-Analysis.Frontiers in oncology · 2021Review
- The role of open radical nephrectomy in contemporary management of renal cell carcinoma.Translational andrology and urology · 2020Review
- Characteristics and Outcome of Children with Renal Cell Carcinoma: A Narrative Review.Cancers · 2020Review
- Emulating Target Clinical Trials of Radical Nephrectomy With or Without Lymph Node Dissection for Renal Cell Carcinoma.Urology · 2020Observational
- Metastatic clear cell renal cell carcinoma in isolated retroperitoneal lymph node without evidence of primary tumor in kidneys: A case report.World journal of clinical oncology · 2020Article
- Valuation of lymph node dissection in localized high-risk renal cell cancer using X-tile software.International urology and nephrology · 2020Article
- Eligibility and Radiologic Assessment for Adjuvant Clinical Trials in Kidney Cancer.JAMA oncology · 2020Article
- Is nodal disease burden relevant in patients with renal cell carcinoma and lymph node invasion?Annals of translational medicine · 2019Article
- Trends and outcomes of lymphadenectomy for nonmetastatic renal cell carcinoma: A propensity score-weighted analysis of the National Cancer Database.Urologic oncology · 2019Article
- The contemporary role of lymph node dissection in the management of renal cell carcinoma.Therapeutic advances in urology · 2018Review
- Perioperative Therapy in Renal Cell Carcinoma: What Do We Know, What Have We Learned, What's Next?Journal of clinical oncology : official journal of the American Society of Clinical Oncology · 2018Review
- A Festschrift in Honor of Edward M. Messing, MD, FACS.Bladder cancer (Amsterdam, Netherlands) · 2018Article
- Accuracy of Nodal Staging and Outcomes of Lymphadenectomy for Non-metastatic Renal Cell Carcinoma: An Analysis of the National Cancer Database.Bladder cancer (Amsterdam, Netherlands) · 2018Article
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9 authors at 9 institutions in 2 countries.
Funding
Abstract
purposeLymphadenectomy is a well established practice for many urological malignancies but its role in renal cell carcinoma is less clear. Our primary objective was to determine whether lymphadenectomy impacted survival in patients with fully resected, high risk renal cell carcinoma. MATERIALS AND
methodsPatients with fully resected, high risk, nonmetastatic renal cell carcinoma were randomized to adjuvant sorafenib, sunitinib or placebo in the ASSURE (Adjuvant Sorafenib and Sunitinib for Unfavorable Renal Carcinoma) trial. Lymphadenectomy was performed for cN+ disease or at surgeon discretion. Patients treated with lymphadenectomy were compared to patients in the trial who did not undergo lymphadenectomy. The primary outcome was overall survival associated with lymphadenectomy. Secondary outcomes were disease free survival, factors associated with performing lymphadenectomy and surgical complications.
resultsOf the 1,943 patients in ASSURE 701 (36.1%) underwent lymphadenectomy, including all resectable patients with cN+ and 30.1% of those with cN0 disease. A median of 3 lymph nodes (IQR 1-8) were removed and the rate of pN+ disease in the lymphadenectomy group was 23.4%. There was no overall survival benefit for lymphadenectomy relative to no lymphadenectomy (HR 1.14, 95% CI 0.93-1.39, p = 0.20). In patients with pN+ disease who underwent lymphadenectomy no improvement in overall or disease-free survival was observed for adjuvant therapy relative to placebo. Lymphadenectomy did not confer an increased risk of surgical complications (14.2% vs 13.4%, p = 0.63).
conclusionsThe benefit of lymphadenectomy in patients undergoing surgery for high risk renal cell carcinoma remains uncertain. Future strategies to answer this question should include a prospective trial in which patients with high risk renal cell carcinoma are randomized to specific lymphadenectomy templates.
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