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Trends of lymphadenectomy in upper tract urothelial carcinoma (UTUC) patients treated with radical nephroureterectomy

World Journal of Urology Aims and scope Submit manuscript

Abstract

Introduction

To evaluate temporal trends in the delivery and extent of lymphadenectomy (LND) in radical nephroureterectomy (RNU) performed in upper tract urothelial carcinoma (UTUC) patients.

Methods

We evaluated a multi institutional collaborative database composed by 1512 consecutive patients diagnosed with UTUC treated with RNU between 1990 and 2016. Year of surgery were grouped in five periods: 1990–1996, 1997–2002, 2003–2007, 2008–2012 and 2013–2016. Data about LND were available for all patients and numbers of nodes removed and positive were reported by dedicate uropathologists. The Mann–Whitney and Chi square tests were used to compare the statistical significance of differences in medians and proportions, respectively.

Results

Five hundred forty-five patients (36.0%) received a concomitant LND while 967 (64.0%) did not; 41.9% of open RNU patients received a concomitant LND compared to 24.4% of laparoscopic RNU patients. The rate of concomitant LND increased with time in the overall, laparoscopic and open RNU patients (all p < 0.03). Patients treated with open RNU also had an increasing likelihood to receive an adequate concomitant LND (p < 0.001) while those undergoing a laparoscopic approach did not (p = 0.1). Patients treated with concomitant LND had a median longer operative time of 20 min (p = 0.01). There were no differences in perioperative outcomes and complications between patients who received a concomitant LND and those who did not (p > 0.1).

Conclusion

Although an increased trend was observed, most patients treated with RNU did not receive LND. Surgeons using a laparoscopic RNU were less likely to perform a concomitant LND, and when done, they remove less nodes.

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Acknowledgements

Marco Moschini is supported by the EUSP Scholarship—European Association of Urology.

Author contributions

Marco Moschini: data collection, statistical analysis, manuscript writing. Beat Foerster: data collection, statistical analysis, manuscript writing. Mohammad Abufaraj: data collection, statistical analysis, manuscript writing. Francesco Soria: data collection. Thomas Seisen: data collection. Morgan Roupret: data collection. Pierre Colin: data collection. Alexandre De la Taille: data collection. Benoit Peyronnet: data collection. Karim Bensalah: data collection. Roman Herout: data collection. Manfred Peter Wirth: data collection. Vladimir Novotny: data collection. Piotr Chlosta: data collection. Marco Bandini: data collection. Francesco Montorsi: data collection. Giuseppe Simone: data collection. Michele Gallucci: data collection. Giuseppe Romeo: data collection. Kazumasa Matsumoto: data collection. Pierre Karakiewicz: project development, manuscript writing. Alberto Briganti: project development, manuscript writing. Shahrokh F. Shariat: project development, manuscript writing.

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Authors and Affiliations

  1. Department of Urology, Comprehensive Cancer Center, Vienna General Hospital, Medical University of Vienna, Vienna, Austria

    Marco Moschini, Beat Foerster, Mohammad Abufaraj, Francesco Soria & Shahrokh F. Shariat

  2. Department of Urology, Urological Research Institute, Vita-Salute University, San Raffaele Scientific Institute, Milan, Italy

    Marco Moschini, Marco Bandini, Francesco Montorsi & Alberto Briganti

  3. Karl Landsteiner Institute of Urology and Andrology, Vienna, Austria

    Marco Moschini, Beat Foerster, Mohammad Abufaraj, Francesco Soria & Shahrokh F. Shariat

  4. Department of Urology, Kantonsspital Winterthur, Winterthur, Switzerland

    Beat Foerster

  5. Academic Department of Urology, Pitié-Salpétrière Hospital, Assistance-Publique Hôpitaux de Paris, Pierre et Marie Curie Medical School, University Paris 6, Paris, France

    Thomas Seisen & Morgan Roupret

  6. Department of Urology, Hôpital Privé de La Louvière, Générale de Santé, Lille, France

    Pierre Colin

  7. Department of Urology, Centre Hospitalier Universitaire Mondor Assistance Publique des Hôpitaux de Paris, INSERM U955Eq07, Paris, France

    Alexandre De la Taille

  8. Department of Urology, Hopital Pontchaillou, CHU Rennes, Rennes, France

    Benoit Peyronnet

  9. Rennes University Hospital (France), Urology, 2 rue Henri Le Guillou, 35000, Rennes, France

    Karim Bensalah

  10. Department of Urology, University Hospital Carl Gustav Carus, Dresden, Germany

    Roman Herout, Manfred Peter Wirth & Vladimir Novotny

  11. Department of Urology, Jagiellonian University, Krakow, Poland

    Piotr Chlosta

  12. 12Department of Urology, “Regina Elena” National Cancer Institute, Rome, Italy

    Giuseppe Simone, Michele Gallucci & Giuseppe Romeo

  13. Department of Urology, Kitasato University School of Medicine, Kanagawa, Japan

    Kazumasa Matsumoto

  14. Department of Urology, University of Montreal, Montreal, QC, Canada

    Pierre Karakiewicz

  15. Department of Urology, University of Texas Southwestern Medical Center, Dallas, TX, USA

    Shahrokh F. Shariat

  16. Department of Urology, Weill Cornell Medical College, New York, NY, USA

    Shahrokh F. Shariat

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  1. Marco Moschini
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  2. Beat Foerster
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  15. Marco Bandini
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  16. Francesco Montorsi
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  17. Giuseppe Simone
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  18. Michele Gallucci
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  19. Giuseppe Romeo
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  20. Kazumasa Matsumoto
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  21. Pierre Karakiewicz
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  22. Alberto Briganti
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  23. Shahrokh F. Shariat
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Corresponding author

Correspondence to Shahrokh F. Shariat.

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All person gave their informed consent to use their data for this retrospective study.

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Moschini, M., Foerster, B., Abufaraj, M. et al. Trends of lymphadenectomy in upper tract urothelial carcinoma (UTUC) patients treated with radical nephroureterectomy. World J Urol 35, 1541–1547 (2017). https://doi.org/10.1007/s00345-017-2026-4

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  • DOI: https://doi.org/10.1007/s00345-017-2026-4

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