Beyond the predictors of lymph node metastases in patients undergoing lymph node dissection for renal cell carcinoma: the impact of tumour side and location

The latest European Association of Urology (EAU) Guidelines on renal cell carcinoma (RCC) recommend offering extended lymph node dissection (LND) to patients with adverse clinical features and performing LND for staging purposes or local control in those with clinically enlarged lymph nodes (1). Of note, the strength of both recommendations is weak. Similarly, the expert opinion of the American Urological Association (AUA) renal cancer Guideline panel is that physicians should perform a lymph node dissection for staging purposes for patients with clinically concerning regional lymphadenopathy but not routinely in patients with localized RCC and clinically negative nodes (2).