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BMC Urology
Published in: BMC Urology 1/2018

Open Access 01-12-2018 | Research article

Role of lymph node dissection in the management of upper tract urothelial carcinomas: a meta-analysis

Authors: Runqi Guo, Yuze Zhu, Gengyan Xiong, Xuesong Li, Kai Zhang, Liqun Zhou

Published in: BMC Urology | Issue 1/2018

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Abstract

Background

Lymph node dissection (LND) is not routinely performed during radical nephroureterectomy (RNU) in upper tract urothelial carcinomas (UTUC) and the role of LND has been controversial. We aim to investigate whether patients with LND had improved survival in UTUC patients.

Methods

We performed a systematic literature search of PubMed, Embase, and Cochrane library for citations published prior to January 2016, describing LND performed among UTUC patients and conducted a standard meta-analysis of survival outcomes.

Results

Eleven eligible studies containing 7516 patients satisfied the inclusion criteria. Pooled HRs for cancer-specific survival (CSS) and recurrence-free survival (RFS) were 1.17 (P = 0.18) and 1.33 (P = 0.19) respectively. However, the patients in the LND group had more advanced tumour stages and grades (P < 0.001). Further subgroup analysis showed that among muscle-invasive UTUC patients, the pooled HR for CSS and RFS were 1.10 (P = 0.42) and 0.92 (P = 0.72) respectively. Besides, no difference was found in CSS and RFS between pN0 and pNx individuals in overall populations and in patients with muscle-invasive UTUC, while pN+ patients had significantly worse prognosis when compared to pN0 patients.

Conclusions

LND during RNU allows more accurate staging and prediction of survival, but it remains uncertain whether LND independently improves survival in patients with UTUC. However, standard use of LND should be further investigated in a multi-center, prospective evaluation to obtain a definitive statement regarding this matter.
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Metadata
Title
Role of lymph node dissection in the management of upper tract urothelial carcinomas: a meta-analysis
Authors
Runqi Guo
Yuze Zhu
Gengyan Xiong
Xuesong Li
Kai Zhang
Liqun Zhou
Publication date
01-12-2018
Publisher
BioMed Central
Published in
BMC Urology / Issue 1/2018
Electronic ISSN: 1471-2490
DOI
https://doi.org/10.1186/s12894-018-0336-5

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