Sathianathen Niranjan J, Risk Michael C, Konety Badrinath R
Department of Urology, University of Minnesota, Delaware Street Southeast, Minneapolis, MN 55455, USA.
Department of Urology, University of Minnesota, Delaware Street Southeast, Minneapolis, MN 55455, USA.
Urol Clin North Am. 2018 May;45(2):215-228. doi: 10.1016/j.ucl.2017.12.006. Epub 2018 Feb 21.
There are currently no reported randomized trials that characterize the staging or therapeutic benefit of performing a lymph node dissection in either bladder cancer or upper tract urothelial carcinoma. Several unanswered questions remain in this domain focused on the indications and patient selection for pelvic lymph node dissection, extent of dissection, its impact on outcome, and potential risks. However, the results of observational studies suggest that the burden of metastasis is high in both diseases when muscle invasive and performing a lymphadenectomy can provide prognostic information and yield therapeutic benefit.
目前尚无关于评估膀胱癌或上尿路尿路上皮癌行淋巴结清扫术的分期或治疗益处的随机试验报告。在这一领域仍存在几个未解决的问题,主要集中在盆腔淋巴结清扫术的适应证和患者选择、清扫范围、对预后的影响以及潜在风险。然而,观察性研究结果表明,在这两种疾病中,当出现肌层浸润时转移负担都很高,而行淋巴结切除术可提供预后信息并产生治疗益处。