Culp Stephen H, Wood Christopher G
Department of Urology, University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA.
Nat Clin Pract Urol. 2009 Mar;6(3):126-7. doi: 10.1038/ncpuro1312. Epub 2009 Feb 10.
While several retrospective studies have suggested a possible benefit of lymph node dissection (LND) for patients with clinically node-positive renal cell carcinoma (RCC), the value of LND in patients with clinically node-negative RCC has remained uncertain. LND undoubtedly improves the accuracy of staging and provides better prognostic information; however, much debate surrounds the impact of LND on progression-free and overall survival in patients with RCC. Additionally, the question remains as to whether LND at nephrectomy is associated with increased morbidity. The final results of the European Organisation for Research and Treatment of Cancer (EORTC) randomized phase III trial 30881 demonstrate that complete LND at nephrectomy does not affect the survival of patients with clinical N0M0 RCC. Importantly, no increase in morbidity was noted in patients who underwent an extended LND compared with no LND, indicating that the performance of LND is unlikely to increase the risk to the patient.
虽然多项回顾性研究表明，淋巴结清扫术（LND）可能对临床淋巴结阳性肾细胞癌（RCC）患者有益，但LND在临床淋巴结阴性RCC患者中的价值仍不确定。LND无疑提高了分期的准确性，并提供了更好的预后信息；然而，关于LND对RCC患者无进展生存期和总生存期的影响存在很多争议。此外，肾切除术时进行LND是否会增加发病率的问题仍然存在。欧洲癌症研究与治疗组织（EORTC）随机III期试验30881的最终结果表明，肾切除术时进行完全LND不会影响临床N0M0 RCC患者的生存。重要的是，与未进行LND的患者相比，接受扩大LND的患者未发现发病率增加，这表明进行LND不太可能增加患者风险。
