上尿路尿路上皮癌的淋巴清扫术进展研究

Discussion on the Lymphnode Dissection of Upper Tract Urothelial Carcinoma

目的:上尿路尿路上皮癌(Upper Tract Urothelial Carcinoma, UTUC)患者在接受根治性肾输尿管切除术合并膀胱袖状切除术时,行区域淋巴结清扫术是否能给患者带来生存益处存在很大的争议。我们将通过这篇综述探讨淋巴清扫术带来的肿瘤学相关益处及风险。方法:通过阅读近十年的相关文献,从资料与方法等方面进行综述。结论:目前无有力证据表明淋巴清扫术(Lymphnode Dissection, LND)能改善UTUC患者的预后,但其可以增加病理分期的准确性并有助于制定辅助治疗策略及个体化随访,在高危患者中行LND对于患者后续治疗方案的选择有着重要的指示意义。

Object: There is a great argument in terms of whether the regional lymph node dissection (LND) is able to bring the survival benefits to patients with urothelial carcinoma in upper urinary tract when undergoing radical nephroureterectomy with bladder cuff excision. We will discuss the oncologic benefits and risks associated with lymphatic dissection in this review. Methods: The related litera-ture of the recent ten years was reviewed from the aspects of materials and methods. Conclusions: There is no strong evidence that lymphnode dissection can improve the survival rate of most pa-tients. However, it can increase the accuracy of pathological staging and help to develop adjuvant treatment strategies and individualized follow-up treatment. The application of LND in high-risk patients has important indicative significance for the selection of follow-up treatment.