文章：

上尿路尿路上皮癌淋巴结清扫术：淋巴结定位研究的批判性评估

Lymph Node Dissection for Upper Tract Urothelial Carcinoma: A Critical Appraisal of Lymph Node Mapping Studies

原文发布日期：29 November 2025

DOI: 10.3390/cancers17233843

类型: Article

开放获取: 是

英文摘要：

Despite the advent and growth of endoscopic and nephron-sparing management approaches, the mainstay treatment for upper tract urothelial carcinoma (UTUC) in 2025 remains radical nephroureterectomy (RNU). Classic teaching, largely derived from the benefit seen in the muscle-invasive bladder cancer (MIBC) population, supports the inclusion of retroperitoneal lymph node dissection (LND), particularly for high-risk and high-grade disease. However, no level 1 evidence exists supporting the inclusion of an LND at the time of extirpative surgery for UTUC. Moreover, studies attempting to map lymph node dissection relative to primary UTUC tumor location are plagued by limitations. Herein, we summarize and review available data regarding proposed LND templates for the management of UTUC.

摘要翻译： 

尽管内镜技术和保留肾单位治疗手段已取得进展并广泛应用，但截至2025年，上尿路尿路上皮癌（UTUC）的主要治疗方式仍为根治性肾输尿管切除术（RNU）。传统理论主要基于肌层浸润性膀胱癌（MIBC）患者群体中观察到的获益，支持在手术中实施腹膜后淋巴结清扫术（LND），尤其针对高风险和高分级病变。然而，目前尚无一级证据支持在UTUC根治性手术中常规进行LND。此外，针对UTUC原发肿瘤部位进行淋巴结清扫范围定位的相关研究仍存在诸多局限性。本文系统总结并评述了当前UTUC治疗中关于淋巴结清扫范围规划方案的相关数据。

原文链接：

Lymph Node Dissection for Upper Tract Urothelial Carcinoma: A Critical Appraisal of Lymph Node Mapping Studies