Factors Associated With Poor Lymph Node Dissection of Colon Neoplasms

8514 Background: The benefits of deep pelvic lymph node dissection (DLND) for node-positive melanoma patients continue to be debated. The objective of our analysis was to assess factors associated with metastatic disease to deep pelvic nodes and examine survival outcomes following DLND. Methods: We retrospectively reviewed the records of 804 patients undergoing lymph node dissection (1990-2001). 97 patients underwent a superficial inguinofemoral lymph node dissection along with a DLND for indications which included: suspicious radiologic imaging (n= 31), documented superficial disease and concern for deep involvement (n = 57), and in-transit disease undergoing limb perfusion (n=9). Logistic regression was performed to identify factors associated with the metastatic tumor spread to deep nodes. Associations between clinicopathologic factors and disease-specific survival (DSS) were estimated using the Cox proportional hazards model. Results: Fifty-four patients (56%) had metastatic disease (median 2 positive lymph nodes, range 1–12) within their deep pelvis. With a median follow-up of 7.5 years, the 5-year DSS was 42% for patients with positive deep pelvic nodes and 52% for those with negative deep pelvic nodes (p = 0.07). When the number of metastatic deep nodes was stratified, the 5-year DSS for patients with 1 positive node, 2–3 positive nodes, and >3 positive nodes was 49%, 48%, and 27%, respectively (p = 0.04). Age ≥ 50 years (odds ratio [OR] = 3.5, p = 0.03), increasing number of positive superficial nodes (OR = 2.1, p < 0.001), and suspicious findings on pelvic CT images (OR = 11.9, p < 0.001) were associated with metastatic deep nodes. In the multivariate analysis, the number of positive deep nodes (hazard ratio [HR] = 1.1, p = 0.03), male gender (HR = 1.9, p = 0.03), and extra-capsular nodal extension of tumor (HR = 2.7, p < 0.001) were identified as adverse prognostic factors for DSS. Conclusions: Survival outcomes in patients with melanoma metastatic to ≤ 3 deep pelvic lymph nodes are comparable to those in patients without deep nodal involvement. These favorable outcomes support an aggressive surgical approach (i.e., DLND) in patients ≥ 50 years, with multiple positive superficial nodes, and suspicious CT findings. No significant financial relationships to disclose.

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PD16-08 INTERNATIONAL AND MULTI-INSTITUTIONAL ASSESSMENT OF FACTORS ASSOCIATED WITH PERFORMANCE AND QUALITY OF LYMPH NODE DISSECTION DURING RADICAL NEPHRECTOMY

The Journal of Urology ◽

10.1016/j.juro.2018.02.820 ◽

2018 ◽

Vol 199 (4S) ◽

Author(s):

E. Charles Osterberg ◽

M. Pilar Laguna Pes ◽

Scott E. Eggener ◽

Bogdan Petrut ◽

Shrawan K. Singh ◽

...

Keyword(s):

Lymph Node ◽

Lymph Node Dissection ◽

Radical Nephrectomy ◽

Node Dissection ◽

Institutional Assessment ◽

Factors Associated

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Factors associated with regional recurrence after lymph node dissection for penile squamous cell carcinoma

BJU International ◽

10.1111/bju.13686 ◽

2016 ◽

Vol 119 (4) ◽

pp. 591-597 ◽

Cited By ~ 4

Author(s):

Jay P. Reddy ◽

Curtis A. Pettaway ◽

Lawrence B. Levy ◽

Lance C. Pagliaro ◽

Pheroze Tamboli ◽

...

Keyword(s):

Squamous Cell Carcinoma ◽

Lymph Node ◽

Cell Carcinoma ◽

Lymph Node Dissection ◽

Squamous Cell ◽

Regional Recurrence ◽

Node Dissection ◽

Factors Associated ◽

Penile Squamous Cell Carcinoma

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Factors linked with receiving a lymph node dissection during surgery for nonmetastatic renal cell carcinoma.

Journal of Clinical Oncology ◽

10.1200/jco.2019.37.7_suppl.672 ◽

2019 ◽

Vol 37 (7_suppl) ◽

pp. 672-672

Author(s):

Kushan Dilip Radadia ◽

Zorimar Rivera-Nunez ◽

Sinae Kim ◽

Nicholas Farber ◽

Joshua Sterling ◽

...

Keyword(s):

Renal Cell Carcinoma ◽

Lymph Node ◽

Cell Carcinoma ◽

Lymph Node Dissection ◽

Renal Cell ◽

Treatment Center ◽

Node Dissection ◽

Factors Associated ◽

Time Of Surgery ◽

To Receive

672 Background: The benefit of a lymph node dissection (LND) in renal cell carcinoma (RCC) remains poorly defined. Despite this uncertainty, the American Urological Association (AUA) guideline on localized renal cancer recommends that LND be performed for staging purposes when there is suspicion of regional lymphadenopathy on imaging. Using the National Cancer Database (NCDB), we examined factors associated with the receipt of LND at the time of renal surgery. Methods: The NCDB was queried for non-metastatic patients who underwent partial nephrectomy or nephrectomy for RCC from 2010 to 2014. Patient socio-demographics, clinical characteristics, and treatment factors were extracted. Logistic regression models were used to examine factors associated with the receipt of LND. Results: We identified 110,963 patients who underwent surgery for RCC, of whom 11,867 (11%) had LND performed at the time of surgery. Clinical lymph node (cLN) and pathologic lymph node (pLN) information were available in 11,300 patients, of which 1,725 were preoperatively staged as having positive cLN. In the entire study population, patients who were cLN positive were approximately 19 times more likely to receive a LND at the time of surgery (OR: 18.68, 95%CI: 16.62-21.00). Factors associated with a LND in patients who are cLN negative (n = 106,370) were assessed. Clinical T (cT) stage was the strongest indicator of LND (cT2-4, OR range: 4.87-11.1). Among both cohorts, patients who received surgery at an academic/research institution or traveled farther ( > 31 miles) to a treatment center were more likely to undergo a LND. Patients from both cohorts who underwent robotic or laparoscopic surgery were less likely to receive a LND compared to open surgery. Conclusions: The greatest predictor of LND receipt is being cLN positive. Among patients who are cLN negative, the greatest predictor of LND is cT stage. Predictors of undergoing LND in all patients and those who are cLN negative include treatment center type and distance to the treatment center. Additional studies to determine the accuracy of clinical staging and assess novel preoperative imaging modalities that evaluate nodal involvement are indicated.

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International and Multi-institutional Assessment of Factors Associated With Performance and Quality of Lymph Node Dissection During Radical Nephrectomy

Urology ◽

10.1016/j.urology.2019.01.068 ◽

2019 ◽

Vol 129 ◽

pp. 132-138 ◽

Cited By ~ 1

Author(s):

E. Charles Osterberg ◽

Shay Golan ◽

M. Pilar Laguna Pes ◽

Scott E. Eggener ◽

Bogdan Petrut ◽

...

Keyword(s):

Lymph Node ◽

Lymph Node Dissection ◽

Radical Nephrectomy ◽

Node Dissection ◽

Institutional Assessment ◽

Factors Associated

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Factors associated with postoperative hypocalcemia following surgery for thyroid cancer in childhood

10.22541/au.162258478.81231072/v1 ◽

2021 ◽

Author(s):

Claudio Spinelli ◽

Marco Ghionzoli ◽

Alessia Bertocchini ◽

Beatrice Sanna ◽

Carlotta Plessi ◽

...

Keyword(s):

Lymph Node ◽

Lymph Node Dissection ◽

Thyroid Surgery ◽

Tumor Size ◽

Pediatric Population ◽

Follicular Carcinoma ◽

Node Dissection ◽

Sample Collection ◽

Postoperative Hypocalcemia ◽

Factors Associated

Background: Postoperative hypocalcemia is a frequent complication after thyroid surgery. Hypoparathyroidism may develop as transient (TtHP), with normalization within six months from surgery, or permanent (PtHP) if the patient requires replacement therapy. The present study analyzes rates and factors associated with the development of TtHP or PtHP following thyroid surgery in a pediatric population. Procedure: A retrospective multicenter study analyzing 363 patients was carried out. We recorded gender, age, tumor size, type of surgery, lymph node dissection, histology. Calcium levels were acquired daily for 72 hours after discharge. Subsequent sample collection was customized on the patient’s hypocalcemia severity. Results: We analyzed 363 patients aged ≤18 years (mean age 14.2 years) who underwent thyroid surgery clustered into age groups (≤15 or >15). Patients mean follow-up was 5.8 years (1-11yrs). At histology 310 (85%) were papillary carcinoma, 32 (9%) were follicular carcinoma, 6 (2%) presented diffuse sclerosing variant of papillary thyroid carcinoma whilst 15 (4%) had familial medullary carcinoma. TtHP developed in 36 (9,9%), PtHP in 20 (5.5%) cases. TtHP was more frequent in younger patients (p=0,009). Both PtHP and TtHP were increased in case of larger tumors (≥2 cm) (p=0,001). All TtHP and PtHP were in TT group. PtHP rate was increased if lymph node dissection was carried out (p<0.001). Conclusions: The risk of hypoparathyroidism is related to younger age, tumor size, TT and lymph node dissection therefore surgeons should tailor surgery as much as possible to avert such complication.

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