Paparel P, Long J-A, Baumert H, Meyer V, Escudier B, Grenier N, Hetet J-F, Rioux-Leclercq N, Lang H, Poissonier L, Soulie M, Patard J-J
Service de chirurgie urologique, centre hospitalier Lyon Sud, 165, chemin du Grand-Revoyet, 69495 Pierre-Bénite cedex, France.
Prog Urol. 2010 May;22(6):313-7. doi: 10.1016/j.purol.2012.01.017. Epub 2012 Feb 28.
Nowadays, most of renal cancers are incidental tumors less than 4 cm. Prevalence of lymph node involvement is low and does not require a systematic lymphadenectomy as described by Robson in the 1960s. Radiologic progress and particularly CT scan describe with high precision lymph node involvement in the initial work-up. In renal cancer with a high risk of recurrence, lymphadenectomy has a pronostic interest and therapeutic role in rare situations where lymph node involvement is isolated. In metastatic patients, the role of cytoreductive nephrectomy has to be assessed.
如今，大多数肾癌是偶然发现的肿瘤，直径小于4厘米。淋巴结受累的发生率较低，不需要像20世纪60年代罗布森所描述的那样进行系统性淋巴结清扫术。放射学的进展，尤其是CT扫描，在初始检查中能高精度地描述淋巴结受累情况。在复发风险高的肾癌中，淋巴结清扫术在淋巴结受累孤立的罕见情况下具有预后意义和治疗作用。在转移性患者中，必须评估减瘤性肾切除术的作用。
