Editing Upper Urinary Tract Urothelial Cancer (section)

====Lymph Node Dissection====

* No RCTs to evaluate the effect of LND on oncologic outcomes in patients undergoing NU or SU
* '''<span style="color:#ff0000">Indications</span>'''
** '''AUA'''
*** '''<span style="color:#ff0000">Recommended (1): HR UTUC</span>'''
**** Sufficient non-randomized evidence to suggest an oncologic benefit to LND at the time of NU for patients with “HR” stratification by guidelines
*** '''<span style="color:#ff0000">Optional (1): LR UTUC</span>'''
**** Limited evidence exists to support a beneficial role for LND at time of NU or ureterectomy among patients with LR UTUC
*'''Template based on tumor collection'''
**'''Pyelocaliceal system: lymph nodes of the ipsilateral great vessel extending from the renal hilum to at least the inferior mesenteric artery.''' 
**'''Proximal 2/3 of the ureter: lymph nodes of the ipsilateral great vessel extending from the renal hilum to the aortic bifurcation.'''
**'''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