The value of lymphography for the TNM classification of renal carcinoma

Preoperative lymphography is a basic condition for uniform tumor classification of renal carcinoma, according to the T, N and M categories. The comparison of 148 lymphographic findings with 170 intraoperative and histopathological lymph node results showed a satisfactory correlation. The total frequency of lymph node metastasis was of 21.6%. Carcinomas with positive lymph nodes showed a significant increase of far distant metastasis up to 50%. Lymph node metastases have to be considered in 10% of all carcinomas of the T1 and T2 categories and in 15.5% of the cases with unclear preoperative lymphographic diagnosis. These results point out the necessity of a radical lymphadenectomy in all T categories.