Clinical Edge

Summaries of Must-Read Clinical Literature, Guidelines, and FDA Actions

In RCC, lymph node dissection does not increase morbidity

Gershmon B et al. European Urology 2018; 73: 469-75.

Key clinical point: Lymph node dissection may be justified in a staging role in renal cell carcinoma as the procedure is not significantly associated with an increased risk of Clavien grade 3 or greater complications, although it may be associated with a modestly increased risk of minor complications.

Major finding: Complications were diagnosed within 30 days of surgery in 194 (9%) patients, including Clavien grade 3 or greater complications in 81 (4%) patients. The most common complication categories were acute renal failure (3%), bleeding (2%), and wound complications (2%). Among patients who underwent lymph node dissection, complications occurred more frequently in patients with pN1 disease—any grade complications occurred in 66 (11%) pN0 and 40 (22%) pN1 patients (p less than 0.001), while Clavien 3 or greater complications occurred in 25 (4%) pN0 and 18 (10%) pN1 patients (p = 0.004).

Study details: A total of 2066 patients who underwent radial neprectomy for M0 or M1 renal cell carcinoma between 1990 and 2010, of whom 774 (37%) underwent lymph node dissection

Disclosures: The researchers declared having no relevant financial disclosures.

Citation:

Gershmon B et al. European Urology 2018; 73: 469-75.