Editing AUA: Upper Tract Urothelial Carcinoma (2023) (section)

===== Lymph node dissection =====
* '''<span style="color:#ff0000">If HR UTUC, LND recommended</span>'''
** No RCTs to evaluate the effect of LND on oncologic outcomes in patients undergoing NU or SU
** Sufficient non-randomized evidence to suggest an oncologic benefit to LND at the time of NU for patients with “HR” stratification by guidelines
** '''Recommended minimal templates in non-metastatic disease'''
*** '''Tumors in the pyelocaliceal system: lymph nodes of the ipsilateral great vessel extending from the renal hilum to at least the inferior mesenteric artery.''' 
*** '''Tumors in the proximal 2/3 of the ureter: lymph nodes of the ipsilateral great vessel extending from the renal hilum to the aortic bifurcation.''' 
*** '''Tumors in the distal 1/3 of the ureter: ipsilateral pelvic LND to include at minimum the obturator and external iliac nodal packets.''' 
*** Internal and common iliac nodal packets may be removed in the appropriate clinical setting.
*** Limited data suggest cranial migration of lymph node metastases to the ipsilateral great vessels such that higher dissection may be considered in the appropriate clinical setting and per clinician judgement
* '''<span style="color:#ff0000">If LR UTUC, LND optional</span>'''
**Limited evidence exists to support a beneficial role for LND at time of NU or ureterectomy among patients with LR UTUC