All lymphadenectomies were carried out by open procedure. Lymph node specimens were sampled ��en bloc�� with surrounding adipose tissue, and were sent to pathological examination as individual packets with the surrounding adipose tissue. No patients underwent incomplete LND that did not include all regional sites in this study. Adjuvant chemotherapy was considered when nodal involvement and/or disease infiltrating the surrounding adipose tissue was observed. However, we made our CP-673451 in vitro
final decision after considering patient comorbidity, performance status and willingness to receive therapy. Chemotherapy consisted of one to three courses of M-VAC (consisting of methotrexate, vinblastine, doxorubicin and cisplatin) or GC regimen (gemcitabine and cisplatin). Univariate analysis was carried out using the Mann�CWhitney U-test to compare patient factors with continuous variables RXDX-106 nmr
between groups. The ��2-test was used to compare patient factors with categorical variables between groups. Survival was calculated with the Kaplan�CMeier method, and statistical significance was analyzed by the log�Crank test. Univariate and multivariate analyses for prognostic factors influencing patient survival were carried out using the Cox proportional hazards model. A difference was considered significant when P?<?0.05. Table?1 shows the characteristics of 90 patients with renal pelvic cancer and 76 with ureteral cancer. The No LND group included more elderly patients for both renal pelvic cancer and ureteral cancer. The distribution of pathological T?stage, tumor grade, and the incidence of lymphovascular invasion was not significantly <a href="https://en.wikipedia.org/wiki/Crotamiton
">crotamiton different between LND and No LND groups in both diseases, showing that oncological backgrounds were very similar between groups. Adjuvant chemotherapy was given significantly more often to the LND group for ureteral cancer. We first analyzed the patients with renal pelvic cancer (Fig.?2). When we included all patients for the analysis, template-based LND significantly improved OS (P?=?0.02, HR 0.32, 95% CI 0.10�C0.87) as compared with the No LND group (Fig.?2a). As a secondary end-point, CSS was also higher in the LND group than the No LND group (P?=?0.01, HR 0.22, 95% CI 0.05�C0.74; Fig.?2b). DFS did not significantly differ between the LND and No LND groups, but the difference was very marginal (P?=?0.05, HR 0.38, 95% CI 0.12�C1.00; Fig.?2c). In addition, LND significantly reduced the incidence of lymphatic metastasis from 20% to 5%, whereas the risk of distant metastasis was not decreased by LND (Table?1). We then focused on patients with pathological T2 or higher, and who were clinically negative for node and distant metastasis (��pT2cN0M0; Fig.?2a�Cc). In 56 patients with renal pelvic cancer at ��pT2cN0M0, the 3-year OS of template-based LND and No LND groups were 86.1% and 48.0%, respectively; the difference is statistically significant (P?=?0.01, HR 0.28, 95% CI 0.07�C0.81).