Performing lymph node dissection (LND) in conjunction with radical nephroureterectomy (RNU) in patients with clinical positive lymph nodes (cN+) with upper tract urothelial carcinoma (UTUC) has no appreciable bearing on overall survival (OS), according to a study published in Urologic Oncology.

This study comprised 423 cN+ patients with UTUC who underwent RNU (median age, 68 years; 57% male) who were identified from the National Cancer Database. In total, 310 patients received LND. The investigators used Kaplan‒Meier plots to estimate survival and Cox proportional hazards regression to assess the impact of LND status on OS.

Following an average follow-up of 1.8 years, the 2-year OS rate was 51.8%. Among the 2 groups, OS was 52.1% and 51.1% in patients who underwent LND vs those who did not (log-rank P=.2). The results of multivariable analysis showed that performing LND had no statistically significant impact on OS (hazard ratio, 0.9; 95% CI, 0.696-1.235; P=.9).

Overall, the researchers concluded that in cN+ patients with UTUC, performing LND in addition to RNU at any clinical stage has no discernible impact on OS.

Reference: Piontkowski AJ, Corsi N, Morisetty S, et al. Benefit of lymph node dissection in cN+ patients in the treatment of upper tract urothelial carcinoma: analysis of NCDB registry. Urol Oncol. 2022;S1078-1439(22)00142-9. doi:10.1016/j.urolonc.2022.04.015

Keywords: Bladder cancer, lymph node dissection, survival, upper tract urothelial carcinoma