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Metastatic Nodal Pattern: Is There a Role for Paraaortic Lymph Node Dissection

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Urothelial Malignancies of the Upper Urinary Tract

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Abstract

The role of lymphadenectomy for upper tract urothelial carcinoma remains an area of controversy, as is the case for many urologic malignancies. Due to vast networks of vascular and lymphatic channels, urothelial carcinoma of both the bladder and upper tract represent diseases where evaluation of the role of meticulous lymph node (LN) dissection has attracted considerable interest from urologic surgeons. Upper tract urothelial carcinoma has the additional consideration of laterality and asymmetry of great vessels and renal vasculature. However, it has a relatively low incidence, which in part has resulted in far fewer studies evaluating the role of LN dissection, and has prevented a full understanding of both its benefits and the optimal extent of dissection to achieve them. That said, the results from multi-institutional studies by high volume centers have supported the beneficial role of LN dissection, more convincingly in staging, but possibly in improving oncological outcomes in select patients. Randomized controlled trials are required to generate a greater level of evidence to create defined templates and establish the role of LN dissection in surgical management of upper tract urothelial carcinoma.

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Authors and Affiliations

  1. Department of Urology, New York Presbyterian Hospital—Weill Cornell Medical Center, 525 East 68th Street, Starr Pavilion, 9th floor, New York, NY, 10065, USA

    David M. Golombos & Douglas S. Scherr

  2. Department of Urology, Weill Cornell Medical College, New York, NY, 10021, USA

    Patrick Lewicki & Jullet Han

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Correspondence to Douglas S. Scherr .

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  1. Chief, Section of Endourology and Minimally Invasive Urology, Westchester Medical Health Network, Valhalla, New York, USA

    Majid Eshghi

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Golombos, D.M., Lewicki, P., Han, J., Scherr, D.S. (2018). Metastatic Nodal Pattern: Is There a Role for Paraaortic Lymph Node Dissection. In: Eshghi, M. (eds) Urothelial Malignancies of the Upper Urinary Tract. Springer, Cham. https://doi.org/10.1007/978-3-319-51263-1_24

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