Phillips E, Messing E M
Department of Surgery, University of Wisconsin School of Medicine, Madison.
Urology. 1993 Jan;41(1):9-15. doi: 10.1016/0090-4295(93)90234-2.
We evaluated the role of lymphadenectomy (LND) in the prevention of local recurrence following radical nephrectomy for renal cell carcinoma (RCC) by two retrospective studies. In one, the relative importance of various tumor characteristics to the subsequent development of local recurrence was investigated in 37 patients who underwent radical nephrectomy and later progressed. In 29 evaluable patients, only nodal metastasis was predictive of local recurrence, which developed in 6 of 7 node-positive patients. In our second study the records of 69 consecutive patients with RCC who underwent radical nephrectomy with or without simultaneous LND (N = 42 and 27, respectively) were reviewed. Local control after LND was excellent in node-positive disease; in no node-positive patient with unilateral RCC has a local recurrence developed (N = 5). LND did not extend hospitalization or add to the morbidity of radical nephrectomy.
我们通过两项回顾性研究评估了淋巴结清扫术（LND）在预防肾细胞癌（RCC）根治性肾切除术后局部复发中的作用。在一项研究中，对37例行根治性肾切除术且随后病情进展的患者，研究了各种肿瘤特征对局部复发后续发展的相对重要性。在29例可评估患者中，只有淋巴结转移可预测局部复发，7例淋巴结阳性患者中有6例发生了局部复发。在我们的第二项研究中，回顾了69例连续行根治性肾切除术的RCC患者的记录，这些患者分别接受了或未接受同期LND（分别为N = 42和27）。在淋巴结阳性疾病中，LND后的局部控制效果极佳；单侧RCC的淋巴结阳性患者均未发生局部复发（N = 5）。LND未延长住院时间，也未增加根治性肾切除术的发病率。
