[Role of lymphadenectomy in the surgical treatment of tumors].

In addition to the excision of the tumor itself, the surgical management of carcinomas includes the removal of regional lymph nodes or lymphadenectomy. The lymphatic system is not the only path of metastatic spread but it is often the main one. The percentage of tumors with lymph node metastases varies with the location and above all with the extent of the tumor at the time of surgery. For example, axillary metastases are much less frequent in cancers discovered by screening mammography than in those with clinical signs. Lymphadenectomy is important for loco-regional control and to determine the prognosis which may dictate adjuvant therapy. In some patients, it also contributes to the cure of their disease by removing lymph nodes metastases that sometimes can only be detected by immunohistochemistry. Lymphadenectomy should be very extensive when done with curative intent and very selective when performed only for prognostic information.