Division of Urologic Surgery, Beth Israel Deaconess Medical Center, Boston, MA 02215, USA.
Division of Urologic Surgery, Beth Israel Deaconess Medical Center, Boston, MA 02215, USA.
Urol Clin North Am. 2020 Aug;47(3):371-377. doi: 10.1016/j.ucl.2020.04.001. Epub 2020 Jun 7.
The role of lymph node dissection (LND) in the management of renal cell carcinoma (RCC) is controversial. LND serves an indisputable staging role by providing pathologic nodal stage. However, while earlier observational studies had suggested a survival benefit to LND, more recent observational evidence and a randomized trial do not support a survival benefit. The majority of patients with isolated lymph node involvement appear to harbor occult metastatic disease. Still, LND is not associated with increased perioperative morbidity when performed in experienced centers. LND may therefore play a predominantly staging role in patients at increased risk of lymph node metastases.
淋巴结清扫术 (LND) 在肾细胞癌 (RCC) 治疗中的作用存在争议。LND 通过提供病理淋巴结分期，具有不可争议的分期作用。然而，尽管早期的观察性研究表明 LND 有生存获益，但最近的观察性证据和一项随机试验并不支持生存获益。大多数孤立淋巴结受累的患者似乎存在隐匿性转移疾病。尽管如此，在经验丰富的中心进行 LND 时，并不会增加围手术期发病率。因此，LND 在有淋巴结转移高风险的患者中主要起分期作用。
