EURURO Vol. 71 No. 4

566 692

validation in patients undergoing partial nephrectomy. In
addition, radiographic lymphadenopathy was recorded from
medical records; accordingly, a specific size threshold could
not be applied, and we could not adjust for the number of
radiographically enlarged nodes. Furthermore, the location
of positive nodes was not available. Finally, exclusion of
patients whose PS was outside the common range may
reduce statistical power and exclude the highest-risk
patients who may potentially benefit from LND, and even
the use of PS techniques cannot adjust for unmeasured
confounding. Still, this study benefits from a large cohort
with long-term follow-up, relatively high utilization of LND
(34%), and the use of PS techniques to adjust for measured
confounding related to nonrandom treatment allocation.
5. Conclusions
LND was not associated with improved oncologic outcomes
in the overall cohort or among patients at increased risk of
nodal disease. Similarly, there was no association between
the extent of LND and survival. These findings do not support
a therapeutic benefit to LND in patients with M0 RCC.
Author contributions: Bradley C. Leibovich had full access to all the data
in the study and takes responsibility for the integrity of the data and the
accuracy of the data analysis.
Study concept and design: Gershman, Thompson, Moreira, Boorjian,
Tollefson, Lohse, Costello, Cheville, Leibovich.
Acquisition of data: Lohse, Thompson, Leibovich.
Analysis and interpretation of data: Gershman, Thompson, Moreira,
Boorjian, Tollefson, Lohse, Costello, Cheville, Leibovich.
Drafting of the manuscript: Gershman, Lohse, Leibovich.
Critical revision of the manuscript for important intellectual content:
Gershman, Thompson, Moreira, Boorjian, Tollefson, Lohse, Costello,
Cheville, Leibovich.
Statistical analysis: Lohse.
Obtaining funding: None.
Administrative, technical, or material support: None.
Supervision: Thompson, Leibovich.
Other: None.
Financial disclosures: Bradley C. Leibovich certifies that all conflicts of
interest, including specific financial interests and relationships and
affiliations relevant to the subject matter or materials discussed in the
manuscript(eg,employment/affiliation,grantsorfunding,consultancies,
honoraria, stock ownership or options, expert testimony, royalties, or
patents filed, received, or pending), are the following: None.
Funding/Support and role of the sponsor: None.
Acknowledgments: This publication was made possible by the Clinical
and Translational Science Award Grant UL1 TR000135 from the National
Center for Advancing Translational Sciences, a component of the
National Institutes of Health. Its contents are solely the responsibility
of the authors and do not necessarily represent the official views of the
National Institutes of Health.
Appendix A. Supplementary data
Supplementary data associated with this article can be
found, in the online version, at
References
[1]
[2]
.
[3]
[4]
[5]
[6]
[7]
[8]
.
[9]
[10]
[11]
.
[12]
[13]
.
[14]
[15]
.
[16]
.
[17]
.
[18]
.
[19]
[20]
E U R O P E A N U R O L O G Y 7 1 ( 2 0 1 7 ) 5 6 0 – 5 6 7 566