Is lymph node metastasis from kidney cancer considered advanced?
Renal cell carcinoma (RCC) accounts for 2% to 3% of all malignancies.
Renal cell carcinoma (RCC) accounts for 2% to 3% of all malignancies in the body, and the TNM stage of the tumor is one of the factors in determining the prognosis of kidney cancer. When kidney cancer develops into locally progressive kidney cancer and metastatic kidney cancer, we call it “advanced kidney cancer”, among which metastatic kidney cancer with lymph node metastasis is “advanced kidney cancer” and is a recognized indicator of poor prognosis.
A very small proportion of patients with lymph node metastases are occult lymph node metastases (lymph node metastases that are not detected by imaging or intraoperative exploration), accounting for about 2% to 3% of all lymph node metastases.
How to detect lymph node metastasis from kidney cancer?
Lymph node metastasis in kidney cancer is mainly manifested by enlarged lymph nodes (lymph node metastasis without lymph node enlargement is rare but does exist) with a lymph node diameter of ≥1 cm; usually lymph nodes of ≥2 cm can be detected by CT, MRI, and other imaging examinations, while lymph nodes of 1 to 2 cm are mainly detected by surgical exploration.
Can kidney cancer with metastatic lymph nodes still be cured?
Can metastatic kidney cancer be cured?
In the treatment of advanced kidney cancer, we focus more on survival rate and do not dare to talk about “cure”. For patients with diagnosed lymph node metastases, there is still a great deal of controversy about whether to perform surgery, especially whether lymph node dissection is needed:
- On the one hand, blindly expanding surgery will increase the risk of surgery, compromise the patient’s immunity, and affect the postoperative quality of life;
- On the other hand, lymph node dissection can improve survival time and quality of life in patients with definite lymph node metastases.
Therefore, the choice of treatment modality is more a matter of further evaluation of the patient’s condition.
In patients with kidney cancer with only lymph node metastases, Giuliani reported a 52% 5-year survival rate after radical kidney cancer surgery + expanded lymph node dissection abroad. For progressive kidney cancer, cytoreduction can also be considered. Cytoreduction is the removal of as much tissue or lymph nodes that have tumor lesions and may be invaded by the tumor to reduce tumor load, alleviate symptoms, improve survival quality, and prolong survival.
In addition, adjuvant therapies such as postoperative biologic therapy and targeted therapy for lymph node metastasis kidney cancer are gradually being implemented, but whether they are beneficial in improving survival in high-risk patients is inconclusive and needs to be tailored to the specific individual situation.