Comparative study of lymph node dissection, and oncological outcomes of laparoscopic and open radical nephroureterectomy for patients with urothelial carcinoma of the upper urinary tract undergoing regional lymph node dissection

Abe, Takashige; Kondo, Tsunenori; Harabayashi, Toru et al.

Japanese journal of clinical oncology, 2018, 48(11), 1001-1011

Permalink : https://hdl.handle.net/2115/72426

このアイテムのアクセス数:720件（2026-10-15 05:22 集計）

閲覧可能ファイル 

ファイル フォーマット サイズ 閲覧回数 説明
hyy128 pdf 475 KB 564

論文情報

ファイル出力 EndNote Basic出力 Mendeley出力

アクセス権
open access
URI
https://hdl.handle.net/2115/72426
タイトル
Comparative study of lymph node dissection, and oncological outcomes of laparoscopic and open radical nephroureterectomy for patients with urothelial carcinoma of the upper urinary tract undergoing regional lymph node dissection
著者
Abe, Takashige ; Kondo, Tsunenori ; Harabayashi, Toru ; Takada, Norikata ; Matsumoto, Ryuji ; Osawa, Takahiro ; Minami, Keita ; Nagamori, Satoshi ; Maruyama, Satoru ; Murai, Sachiyo ; Tanabe, Kazunari ; Shinohara, Nobuo
e-Rad_Researcher
10399842
著者名
Abe, Takashige
著者名
Kondo, Tsunenori
著者名
Harabayashi, Toru
著者名
Takada, Norikata
著者名
Matsumoto, Ryuji
著者名
Osawa, Takahiro
著者名
Minami, Keita
著者名
Nagamori, Satoshi
e-Rad_Researcher
80507591
著者名
Maruyama, Satoru
著者名
Murai, Sachiyo
著者名
Tanabe, Kazunari
e-Rad_Researcher
90250422
著者名
Shinohara, Nobuo
言語
英語
キーワード
urothelial carcinoma
upper urinary tract
laparoscopic nephroureterectomy
open nephroureterectomy
lymph node dissection
発行日
2018-11-01
出版者
Oxford University Press
収録物名
Japanese journal of clinical oncology
巻(号)
48(11)
ページ
1001-1011
抄録
Objective: To assess the number of lymph nodes removed as a surrogate marker of the extent of lymph node dissection, and compare survival outcomes between laparoscopic radical nephroureterectomy (LRNU) and open radical nephroureterectomy (ORNU) in patients undergoing standardized lymph node dissection. Methods: We retrospectively analyzed the data of 214 cTanyN0M0 patients undergoing radical NU with regional lymph node dissection according to the tumor location. The Kaplan-Meier method and Cox hazards model were utilized for survival analyses, including recurrence-free survival (RFS), cancer-specific survival (CSS) and overall survival (OS). Results: A total of 114 patients underwent LRNU and 100 underwent ORNU. There was no significant difference in the pT stage, pN stage, or tumor grade, but distal ureteral tumors were more frequent in the LRNU group. The number of lymph nodes removed did not differ between the two groups [LRNU: 12 (median), ORNU: 11.5, P = 0.3852]. Lymph node metastasis was pathologically identified in 19 patients (8.9%). The 5-year RFS (ORNU: 71.7%, LRNU: 74%, P = 0.7829), CSS (77.8 and, 80%, P = 0.8441) and OS (72.8, and 75.9%, P = 0.3456) did not differ between the two groups. In the sub-analysis of pT3/4 patients (n = 83), there were no significant differences in RFS, CSS, or OS between the two groups, although Kaplan-Meier survival curves were slightly better for those receiving ORNU. In the multivariate model, LRNU was not significantly correlated with a poorer RFS, CSS or OS. Conclusion: Our data support the feasibility of lymph node dissection with a laparoscopic approach and the equivalent oncological outcome of LRNU compared with ORNU when regional lymph node dissection is performed. However, LRNU should be performed after careful patient selection for advanced disease.
資源タイプ
学術雑誌論文
出版タイプ
Version of Record
権利情報
Creative Commons Attribution-NonCommercial 4.0 International
PISSN
0368-2811
関連情報 (isIdenticalTo)
出版社版DOI
https://doi.org/10.1093/jjco/hyy128