Recent studies showed the therapeutic benefit of lymphadenectomy in advanced stage urothelial carcinoma of the upper urinary tract, but there is still a lack of prospective studies. Thus, the current guideline recommends lymph node dissection for invasive upper tract urothelial carcinoma (UTUC) on the basis of insufficient evidence. Also, the preoperative judgment of muscle invasive pathological stage T 2+,or N+ is difficult from preoperative imaging. In the investigators' clinical practice, the surgeons performed dissection of regional lymph nodes only in patients with enlargement of lymph nodes found in preoperative imaging or during surgery. The aim of this multi-institutional study was to examine the role of lymphadenectomy in urothelial carcinoma of the upper urinary tract.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
TRIPLE
Enrollment
504
Template-based LND was carried out in all patients in this group. The anatomical extent of LND is described in previous study. Lymph node specimens were sampled "en bloc" with surrounding adipose tissue, and were sent to pathological examination as individual packets with the surrounding adipose tissue.
LND was carried out only in patients who have lymph nodes enlargement in preoperative imaging (e.g. CTU or enhanced MRI) or who were found lymph nodes enlargement during surgery
Peking University First Hospital
Beijin, Beijin, China
RECRUITINGRenji Hospital, School of Medicine, Shanghai Jiao Tong University
Shanghai, Shanghai Municipality, China
RECRUITINGDisease free survival
Disease free survival rate in the 36 month following nephroureterectomy
Time frame: 36 month
Cancer specific survival
Cancer specific survival rate in the 36 month following nephroureterectomy
Time frame: 36 month
Overall survival
Overall survival rate in the 36 month following nephroureterectomy
Time frame: 36 month
The recurrence rate of bladder cancer in the 36 month following nephroureterectomy
The recurrence rate of bladder cancer in the 36 month following nephroureterectomy
Time frame: 36 month
Perioperative complications rate
Perioperative complications were evaluated up to 90 days after surgery, and were graded by Clavien-Dindo classification
Time frame: 90 day
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