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コバヤシ ヒロヒト
Kobayashi Hirohito
小林 博人 所属 医学部 医学科（附属足立医療センター） 職種 准教授 |
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| 論文種別 | 原著 |
| 言語種別 | 英語 |
| 査読の有無 | 査読あり |
| 表題 | Template-based lymphadenectomy reduces the risk of regional lymph node recurrence among patients with upper/middle ureteral cancer. |
| 掲載誌名 | 正式名：International journal of clinical oncology 略 称：Int J Clin Oncol ISSNコード：14377772/13419625 |
| 掲載区分 | 国外 |
| 巻・号・頁 | 22(1),pp.145-152 |
| 著者・共著者 | Kondo Tsunenori, Hara Isao, Takagi Toshio, Kodama Yoshiki, Hashimoto Yasunobu, Kobayashi Hirohito, Iizuka Junpei, Omae Kenji, Yoshida Kazuhiko, Tanabe Kazunari |
| 発行年月 | 2017/02 |
| 概要 | BACKGROUND:Our previous nonrandomized prospective study showed that template-based lymphadenectomy improved survival among patients with renal pelvic cancer but not among patients with ureteral cancer. However, regional node sites vary according to the tumor's location in relation to the ureter. Therefore, this retrospective study examined the therapeutic role of lymphadenectomy for ureteral cancer according to tumor location.METHODS:Between January 1988 and September 2015, we performed nephroureterectomy for 154 patients with nonmetastatic urothelial carcinoma of the ureter at two Japanese institutions. The tumors' locations were classified as the lower ureter or the upper/middle ureter (before the cranial crossing of the common iliac artery). The appropriate regional nodes were identified based on our previous mapping study. Dissection was classified as complete lymphadenectomy (all regional sites were dissected), incomplete lymphadenectomy (not all sites were dissected), or no lymphadenectomy. We focused the analyses on patients with ≥pT2 disease to clarify the effect of the lymphadenectomy.RESULTS:Among the 48 patients with upper/middle ureteral cancer, recurrence-free and cancer-specific survival were significantly higher in the complete lymphadenectomy group (vs. the incomplete or no lymphadenectomy groups). However, there were no differences in recurrence-free and cancer-specific survivals among the 56 patients with lower ureteral cancer. In the patients with upper/middle ureteral cancer, multivariate analysis revealed that template-based lymphadenectomy was independently associated with a reduced risk of cancer-specific mortality.CONCLUSIONS:Template-based lymphadenectomy has a therapeutic benefit for treating patients with upper/middle ureteral cancer but not for treating patients with lower ureteral cancer. |
| DOI | 10.1007/s10147-016-1024-7 |
| PMID | 27450420 |