Lymphadenectomy Combined with Radical Nephrectomy: To Do or Not to Do?

In this issue of European Urology, the European Organization for Research and Treatment of Cancer (EORTC) Genito-urinary Group presents the final results of a randomized phase 3 trial started 20 yr ago comparing radical nephrectomy with lymphadenectomy to radical nephrectomy alone [1]. Seven hundred and thirty-two patients with preoperatively staged N0 M0 tumors were eligible. The 4% incidence of unsuspected lymph node metastases was (expectedly) low, and thus, no survival advantage of a regional lymph node dissection in conjunction with radical nephrectomy could be demonstrated.