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EDITORIAL COMMENT

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The authors performed a multicenter retrospective evaluation of 1029 patients with upper urinary tract urothelial carcinoma (UTUC) who underwent nephroureterectomy at 10 Canadian institutions between 1990 and 2010. They assessed survival in patients with positive and negative lymph node disease, and evaluated the association between the number of positive nodes, the number of nodes removed, and the ratio of positive nodes to total nodes removed (lymph node density). The study confirmed known outcomes: that those patients with N+ disease have significantly shorter overall survival, disease-specific survival, and recurrence-free survival compared with patients with NO and NX disease. Interestingly, however, the authors show that a lymph node density of >=20% was associated with significantly worsening overall survival (OS), disease-specific survival (DSS), and recurrence-free survival (RFS) compared with patients with a lymph node density of <20%, and this finding remained positive even after assessment of nodal density as a continuous measure. However, the number of positive nodes and the number of nodes removed were not associated with survival in any analysis. The authors concluded that it remains uncertain whether lymph node dissection independently improves survival in patients with UTUC. The authors
机译：作者对1990年至2010年间在加拿大10家机构接受了肾结直肠切除术的1029例上尿路尿路上皮癌（UTUC）患者进行了多中心回顾性评估。他们评估了淋巴结阳性和阴性患者的生存率，并评估了淋巴结转移的相关性。正节点数，已删除节点数以及正节点与已删除节点总数之比（淋巴结密度）。该研究证实了已知的结果：与NO和NX疾病患者相比，那些N +疾病患者的总生存期，疾病特异性生存期和无复发生存期明显缩短。然而，有趣的是，作者表明，与淋巴结转移的患者相比，> 20％的淋巴结密度与总体生存期（OS），疾病特异性生存期（DSS）和无复发生存期（RFS）显着恶化有关。淋巴结密度＜20％，即使连续评估淋巴结密度后，该发现仍为阳性。但是，在任何分析中，阳性结节的数目和去除的结节的数目均与生存率无关。作者得出结论，目前尚不确定淋巴结清扫术是否能独立提高UTUC患者的生存率。作者

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