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Renal Cancer pp 281-294 | Cite as

Role of Lymphadenectomy in Renal Cell Cancer

  • Mattias Willem van Hattem
  • Eduard Roussel
  • Hendrik Van Poppel
  • Maarten AlbersenEmail author
Chapter

Abstract

Surgical extirpation of regional lymph nodes in the treatment of renal cell carcinoma (RCC) is currently accepted as the most accurate staging procedure for the detection of lymph node invasion (LNI). However, therapeutic benefit still remains controversial. The renal lymphatic drainage is unpredictable, and the extent of lymph node dissection (LND) is a matter of debate. Small lymph node metastases cannot be visualized by the currently available imaging techniques. The European Organization for Research and Treatment of Cancer (EORTC) trial number 30881 shows that performing LND in patients with T1–T2 clinically node-negative (cN0) RCC offers limited staging information and no benefit in terms of decreasing disease recurrence or improving survival. Several retrospective studies show that high-risk patients with advanced or metastatic disease should undergo LND because of the important staging role of LND and because some of them may benefit from a therapeutic effect. Conversely, lately some recent studies presented data contesting a therapeutic benefit for LND, suggesting only a staging role of LND in the contemporary surgical management of RCC. In this chapter, the available evidence is summarized, and implications on clinical practice of lymph node staging in RCC are discussed.

Keywords

Renal cell cancer Renal cell carcinoma Lymphatic drainage Lymphadenectomy Lymph node dissection Nephrectomy 

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Copyright information

© Springer Nature Switzerland AG 2020

Authors and Affiliations

  • Mattias Willem van Hattem
    • 1
  • Eduard Roussel
    • 1
  • Hendrik Van Poppel
    • 1
  • Maarten Albersen
    • 1
    Email author
  1. 1.Department of UrologyUZ LeuvenLeuvenBelgium

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