What is the role of lymphadenectomy in radical nephrectomy?

Updated: Feb 05, 2019
  • Author: Richard A Santucci, MD, FACS; Chief Editor: Bradley Fields Schwartz, DO, FACS  more...
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Answer

The role of regional lymphadenectomy in patients with localized kidney cancer is controversial. Because no widely effective treatments are available for metastatic RCC, proponents argue that if only small nodes are involved, regional lymphadenectomy may benefit a small number of patients. Extensive nodal involvement portends a poor prognosis. Patients with lymphatic metastasis commonly demonstrate synchronous or metachronous distant metastasis; thus, regional lymphadenectomy is of no benefit. Despite a lack of randomized controlled studies, current data suggest that some patients can benefit from regional lymphadenectomy, especially the subset of patients with micrometastatic lymph node involvement.


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