Lymphadenectomy in Renal Adenocarcinoma

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Abstract
From 1968-1978, 241 patients underwent radical nephrectomy for renal adenocarcinoma. The regional lymph nodes were resected in 102 patients with disease localized to the kidney including the following: resection of all nodal tissue from the diaphragm to aortic bifurcation, resection of ipsilateral nodes from the renal pedicle to the inferior mesenteric artery, or incidental lymph node resection. Of 9 patients with evidence of lymph node metastases, only 1 remained free of disease 7 yr postoperatively. This patient had only a single hilar lymph node as evidence of metastatic disease. A limited rather than an extended lymphadenectomy is a suggested addition to a radical nephrectomy in patients with locally resectable renal adenocarcinoma without evidence of distant lymph node or parenchymal metastases.