Summary
1. The prognosis of 381 patients operated on for renal cell carcinoma without distant metastases depended on the extent of radical nephrectomy along with lymphadenectomy. After partial lymph-node dissection (PLD), the uncorrected survival rates determined by the actuarial method were 64±8% after 3 years and 50±9% after 5 years compared to 77±7% (3 years) and 60±11% (5 years), when complete lymph-node dissection (CLD) was performed. 2. For stage I (pT 1+2) the better results in the CLD-group (88±10% 5-year survival rate for CLD; 67±13% 5-year survival rate for PLD) are partially explained as a staging-effect, whereas in the periorganic stage II (pT 3 a), the difference (92±10% 5-year survival rate for CLD; 45±25% 5-year survival rate for PLD) is due to the higher radicality of nephrectomy, with systematic dissection and removal of a larger area of borderline tissue. In stage III (35±14% 5-year survival rate for CLD; 37±12% 5-year survival rate for PLD), the predominant influence of macroscopic venous involvement could not be changed very much by local extension of the operation. Only 5.6% of all patients (CLD with stage III b) had positive lymph nodes alone. The whole group with positive lymph nodes (stage III b+c=22% in CLD) seemed to benefit from systematic dissection (32±19% 5-year survival rate for CLD, 11±19% 5-year survival rate for PLD; difference not significant). 3. The incidence of lymph-node metastases was 14% (N=170) in the PLD-group and 23% (N=211) in the CLD-group (stage IV included). When only partial dissection was done, 30% of the lymph-node metastases were not detected.
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Herrlinger, A., Schrott, K.M., Sigel, A. et al. Results of 381 transabdominal radical nephrectomies for renal cell carcinoma with partial and complete en-bloc lymph-node dissection. World J Urol 2, 114–121 (1984). https://doi.org/10.1007/BF00328090
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DOI: https://doi.org/10.1007/BF00328090