[What is the benefit of systematic regional lymph node dissection in tumor nephrectomy?].

What is the benefit of an extended dissection of the regional lymph nodes in the treatment of renal cell carcinoma (RCC)? We evaluated the results of 511 consecutive patients which we operated on RCC. The data of 320 patients (SLD) who had an extended dissection of the regional lymph nodes have been compared with those of 191 patients (FLD) who had a dissection of none or only of a few nodes for staging reasons. All patients were nephrectomized under curative intent (M0) with a transabdominal approach. 1. The incidence of N+ in the SLD group was 17.5% and 10% in the FLD group. 2. The overall 5-year survival rates were 58% after FLD and 66% after SLD, the 10-year survival rates 38% after FLD and 54% after SLD (p less than 0.01). 3. The perioperative mortality of patients with extended dissection was 0.9%. We conclude from our data that the extended dissection of the regional lymph nodes significantly improves the prognosis of patients which were operated for RCC.