ArticleUrologic oncology2022
Benefit of lymph node dissection in cN+ patients in the treatment of upper tract urothelial carcinoma: Analysis of NCDB registry.
Article in Urologic oncology, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT07321210 (Clinical Efficacy and Safety of Radical Nephroureterectomy With Versus Without Template Lymph Node Dissection in High-Risk Upper Tract Urothelial Carcinoma), which is not on this map. Cited by 5 papers.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Clinical Efficacy and Safety of Radical Nephroureterectomy With Versus Without Template Lymph Node Dissection in High-Risk Upper Tract Urothelial Carcinoma: A Multicenter, Prospective, Randomized Controlled Clinical Trial
Who cites it
5 citing papers in PubMed.
- A pathological complete response and adrenal insufficiency in a patient with advanced renal pelvic cancer treated with pembrolizumab.International cancer conference journal · 2024Article
- Narrative review of nephron-sparing surgical management of upper tract urothelial carcinoma: is there a role for distal ureterectomy, segmental ureterectomy, and partial nephrectomy.Translational andrology and urology · 2024Review
- Lymph Node Dissection in Upper Tract Urothelial Carcinoma: Current Status and Future Perspectives.Current oncology reports · 2023Review
- The Association between Lymph Node Dissection and Survival in Lymph Node-Negative Upper Urinary Tract Urothelial Cancer.Cancers · 2023Article
- Benefits of lymphadenectomy for upper tract urothelial carcinoma only located in the lower ureter: a bicentre retrospective cohort study.Frontiers in oncology · 2023Article
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11 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesThe benefits of lymph node dissection (LND) in surgically treated upper tract urothelial carcinoma (UTUC) patients who present with clinically positive nodes at diagnosis remain unclear. The aim of this study was to assess survival differences in cN+ patients who underwent radical nephroureterectomy (RNU) with LND vs. without LND.
methodsThe National Cancer Database was used to identify a total number of 423 cN+ patients from 2004 to 2016 with UTUC that underwent RNU. Of the 423 patients, 310 received LND. Kaplan-Meier (KM) plots were used to estimate survival in cN+ patients who received RNU with LND vs. without. Cox proportional hazards regression tested the impact of LND status on overall survival (OS) after adjusting for all available covariates.
resultsMedian age of the patient population was 68 years (IQR 61-76), and 56.74% were male. Median follow-up was 1.8 years (IQR 0.9-3.5). For the entire cohort, the 2-year OS rate was 51.8%, and it was 52.1% vs. 51.1% in patients who underwent LND vs. not (log-rank p-value=0.2). On multivariable analysis, performing LND had no statistically significant impact on OS (HR 0.93 95%CI 0.696-1.235, P = 0.9). Repeating the analysis in patients who had exclusively cN1 (HR 0.76 95%CI 0.469-1.223, P = 0.26) or cN2/3 (HR 0.844 95%CI 0.556-1.28, P = 0.43) disease also failed to demonstrate a significant impact of LND on survival.
conclusionIn cN+ patients with UTUC, performing LND in addition to RNU at any clinical stage does not seem to have a significant impact on OS.
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