Mp51-19 Regional Lymph Node Dissection Is Associated With Improved Survival for Patients With Urothelial Cell Carcinoma Undergoing Definitive Surgery

You have accessJournal of UrologyKidney Cancer: Epidemiology & Evaluation/Staging/Surveillance II (MP51)1 May 2024MP51-19 REGIONAL LYMPH NODE DISSECTION IS ASSOCIATED WITH IMPROVED SURVIVAL FOR PATIENTS WITH UROTHELIAL CELL CARCINOMA UNDERGOING DEFINITIVE SURGERY Abigail L. Kohut-Jackson, Krithika Kumanan, and Zachary Hamilton Abigail L. Kohut-JacksonAbigail L. Kohut-Jackson , Krithika KumananKrithika Kumanan , and Zachary HamiltonZachary Hamilton View All Author Informationhttps://doi.org/10.1097/01.JU.0001009492.49624.4b.19AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Recent updates to AUA guidelines now include regional lymph node dissection (LND) with radical nephroureterectomy as the standard of care for surgical treatment of upper tract urothelial cell carcinoma (UTUC). The survival benefit of LND in this setting is unclear. Our aim was to evaluate overall survival outcomes for patients with UTUC undergoing radical nephroureterectomy or ureterectomy from the National Cancer Database, stratified by LND. METHODS: The National Cancer Database was queried for patients with UTUC, cTanyN0M0 and cTanyN+M0, stratified by LND (pN0-1) versus no lymph node dissection (pNx) from 2006-2016. 17,455 patients met criteria for analysis; 9,365 patients had primary renal tumors (arising in the kidney or renal pelvis), and 8,090 patients had primary ureteral tumors. We retrospectively analyzed trends in overall survival and 30- and 90-day mortality. RESULTS: In the 9,365 patients with primary renal or renal pelvis tumors, 68.3% had cT1 disease and 31.7% had cT2-4 disease. Additionally, 4,332 (46.3%) underwent LND with 4.6% having pN+ disease. LND was associated with lower overall mortality when compared with no LND (36.6% versus 43.4%, p<0.001). In the 8,090 patients with primary ureteral tumors, 71% had cT1 disease and 29% had cT2-4 disease. Furthermore, 3,866 (47.8%) underwent LND and 3.2% had pN+ disease. Similarly, LND was associated with lower overall mortality when compared with no LND (37.2% versus 49.7%, p<0.001). However, LND was not associated with mortality within 30- or 90-days in either group. CONCLUSIONS: LND in the setting of radical nephroureterectomy or ureterectomy is underutilized, with less than half of patients with primary renal or primary ureteral tumors receiving LND from 2006-2016. Our analysis demonstrates a potential survival benefit associated with LND for patients with UTUC. Source of Funding: N/A © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e850 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information Abigail L. Kohut-Jackson More articles by this author Krithika Kumanan More articles by this author Zachary Hamilton More articles by this author Expand All Advertisement PDF downloadLoading ...