Lymphadenectomy in renal adenocarcinoma

From 1968 to 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 1) resection of all nodal tissue from the diaphragm to aortic bifurcation, 2) resection of ipsilateral nodes from the renal pedicle to the inferior mesenteric artery or 3) incidental lymph node resection. Of 9 patients with evidence of lymph node metastases only 1 remained free of disease 7 years postoperative. 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.