The prognostic role of lymph node dissection counts in the management of renal cell carcinoma: A large international cohort study

Abstract

The count of lymph node dissection (LND) has been confirmed as a prognostic indicator in various cancers while the correlation between LND counts and patient prognosis in renal cell carcinoma (RCC) was not fully studied. This research evaluated the link between LND counts and the prognosis of RCC patients. This study obtained RCC patients from the SEER database between 2010 and 2014. Univariate and multivariate Cox regression analyses were used to assess the predictive and prognostic value of LND. Besides, Kaplan–Meier (KM) survival analysis was used for survival analysis. Finally, 1264 patients were included in this study, which were divided into none LND groups (249), 1–3 LND groups (166), and 4 or more LND groups (549). Age, laterality, stage, M stage, and grade were statistically different among the three groups. In univariate Cox analysis, stage, M stage, T stage, and grade were significantly correlated with overall survival (OS). In multivariate Cox regression analysis, age, race, stage, T stage, and grade were used as independent prognostic factors. KM survival analysis revealed that grade, T stage, M stage, and stage were significantly correlated with OS. Subgroup analysis revealed that LND counts were not significantly associated with survival risk in subgroups with different clinical factors. The current North American population analysis revealed that age, race, stage, T stage, and grade may be used as independent prognostic factors for patients with RCC. Moreover, the increasing LND counts during surgery may not improve the tumor outcomes of RCC patients.