Introduction/Aim: Indications, techniques and outcomes of lymph node dissection (LND) for upper tract urothelial carcinoma (UTUC) are still debated. Although potential benefits of LND have been described in literature, hesitancy and lack of standardization still exists even among academic institutions. The aim of the study was to provide a comprehensive overview on anatomical landmarks of LND for UTUC and propose evidence-based templates according to the location of the primary tumor. Materials and Methods: A systematic review of the English-language literature up to June 1, 2015, was performed using the Medline, Scopus and Web of Sciences databases according to the PRISMA criteria. Cohort studies providing detailed data on the surgical template of LND were included and analyzed. Results: A total of 702 articles were identified. After study selection, 16 studies recruiting 1,705 patients were selected for review and critically analyzed. Among these, most were single-centre, retrospective cohort studies, of which 2 mapping studies. Sample size, tumor location and stage were highly variable across the published series. An open surgical approach was used in most cases. No standardized selection criteria for LND were followed, being LND performed at surgeon’s discretion and/or based on pre/intraoperative suspicion of LN metastases. In most studies, the extent of LND was not standardized. An overview of the LND templates according to the current literature are shown in Figure 1, while the proposed standardized templates based on the available mapping studies in Figure 2 (A-C). Discussion and Conclusion: Indications and templates of LND for UTUC are still controversial. We have proposed standardized evidencebased templates to improve the quality of future clinical series. Further research is needed to validate these templates to understand the exact patterns of lymphatic drainage from UTUCs.

ANATOMICAL LANDMARKS AND SURGICAL TEMPLATES OF LYMPHNODE DISSECTION FOR UPPER TRACT UROTHELIAL CARCINOMA: A SYSTEMATIC REVIEW OFTHE LITERATURE / Riccardo Campi; Andrea Minervini; Francesco Sessa; Tommaso Chini; Riccardo Tellini; Davide Facchiano; Marco Roscigno; Sergio Serni; Marco Carini. - In: ANTICANCER RESEARCH. - ISSN 0250-7005. - STAMPA. - 36:(2016), pp. 2594-2596.

ANATOMICAL LANDMARKS AND SURGICAL TEMPLATES OF LYMPHNODE DISSECTION FOR UPPER TRACT UROTHELIAL CARCINOMA: A SYSTEMATIC REVIEW OFTHE LITERATURE

Riccardo Campi;MINERVINI, ANDREA;SERNI, SERGIO;CARINI, MARCO
2016

Abstract

Introduction/Aim: Indications, techniques and outcomes of lymph node dissection (LND) for upper tract urothelial carcinoma (UTUC) are still debated. Although potential benefits of LND have been described in literature, hesitancy and lack of standardization still exists even among academic institutions. The aim of the study was to provide a comprehensive overview on anatomical landmarks of LND for UTUC and propose evidence-based templates according to the location of the primary tumor. Materials and Methods: A systematic review of the English-language literature up to June 1, 2015, was performed using the Medline, Scopus and Web of Sciences databases according to the PRISMA criteria. Cohort studies providing detailed data on the surgical template of LND were included and analyzed. Results: A total of 702 articles were identified. After study selection, 16 studies recruiting 1,705 patients were selected for review and critically analyzed. Among these, most were single-centre, retrospective cohort studies, of which 2 mapping studies. Sample size, tumor location and stage were highly variable across the published series. An open surgical approach was used in most cases. No standardized selection criteria for LND were followed, being LND performed at surgeon’s discretion and/or based on pre/intraoperative suspicion of LN metastases. In most studies, the extent of LND was not standardized. An overview of the LND templates according to the current literature are shown in Figure 1, while the proposed standardized templates based on the available mapping studies in Figure 2 (A-C). Discussion and Conclusion: Indications and templates of LND for UTUC are still controversial. We have proposed standardized evidencebased templates to improve the quality of future clinical series. Further research is needed to validate these templates to understand the exact patterns of lymphatic drainage from UTUCs.
2016
Riccardo Campi; Andrea Minervini; Francesco Sessa; Tommaso Chini; Riccardo Tellini; Davide Facchiano; Marco Roscigno; Sergio Serni; Marco Carini
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Utilizza questo identificatore per citare o creare un link a questa risorsa: https://hdl.handle.net/2158/1056670
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