Radical Nephrectomy With Systematic Lymphadenetomy

Objectives: The value of systematic lymphadenectomy has been a matter of great controversy for a long period of time. A retrospective study was performed to evaluate the long-term curative effect of radical nephrectomy (RN) with systematic lymphadenectomy. Patients and methods: Since 1987 March, 94 patients (male 61, female 33,mean age 52.8) underwent RN with systematic lymphadenectomy in Nan fang Hospital. Comparing with the published papers, we analyzed the 3-year and 5-year survival rate of these different TNM-classified patients who underwent the operation and was followed up. Results: The over-all 1-year survival rate of PT14N0M0 patients was 100%(with lymph node metastases?4.7%, with distant metastases?6.7%). The 3-year survival rate of patients of PT12N0M0, PT3NOMO, PT4NOMO and with lymph node metastases was 92.5 %,83 0o,60%and 58.8%, respectively. 2 of 5 patients with distant met astases were alive. The over-all survival rate was 65.6% at five years(five-year survival rate:stage PTL..2NOM 81.800, stage PT3NOMO 7000, stage PT13N0M0 79.1 00, stage PT4NOMO 400o ,46.2 OQ for patients with lymph node metastases),and none of three patients with distant metastases survived. One patient died in operation, and three had suffered lymphatic fistula about one week after operation. Conclusion: Compared with routine RN, RN with systematic lymphadenectomy may improve detective rate by 6~7%. The patients were diagnosed pathologically, and the lymph node metastases were dissected synchronously. RN with systematic lymphadenectomy may also improve 5-year survival rate of RCC, compared with routine RN, and the patients of PT13N0M0 benefit from it principally. But the two methods have the same curative effects for patients of PT4 and those with distant metastases.