Palapattu Ganesh S, Kim Hyung L, Belldegrun Arie S
Rev Urol. 2003 Summer;5(3):196-9.
It is necessary to consider the potential risks and benefits of performing a lymph node dissection (LND) at the time of radical nephrectomy. LND may lead to more accurate staging, a decrease in local recurrence, and an increase in survival for patients with metastatic disease limited to the resected lymph nodes. However, there are risks associated with the treatment that must be considered. The advantages of LND vary among patients, depending on the location and extent of disease progression. For patients with stage T3 or T4 disease, we recommend a limited LND. Patients with T3 or T4 disease with grossly positive nodes with or without hematogenous metastasis should undergo a more extensive LND.
在根治性肾切除术时,有必要考虑进行淋巴结清扫术(LND)的潜在风险和益处。对于转移性疾病局限于切除淋巴结的患者,LND可能会带来更准确的分期、局部复发率降低以及生存率提高。然而,必须考虑该治疗所伴随的风险。LND的优势因患者而异,取决于疾病进展的部位和程度。对于T3或T4期疾病的患者,我们建议进行有限的LND。伴有或不伴有血行转移且淋巴结明显阳性的T3或T4期疾病患者应接受更广泛的LND。