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The lymph nodes have to be looked at under a microscope."Ī goal of the research is to contribute data to standardizing surgical practice for Wilms tumor and other kidney cancer, Cost says. "They could be microscopically involved and we have no way of knowing during surgery whether that's the case. "Just because lymph nodes don't look involved when we're performing surgery doesn't mean they're not," Cost says. Lymph node sampling can be an important factor in staging Wilms tumor, helping clinicians assess whether the cancer has spread beyond the tumor. Of the small number of complications reported, small bowel obstruction was the most common in both groups. In analyzing the number of lymph nodes sampled and its influence on the odds of the child experiencing complications, the researchers found that there was no statistically significant difference in clinically significant complications between patients who underwent more extensive lymph node sampling than those who didn't. To understand outcomes following lymph node sampling during surgery to remove Wilms tumor, a type of kidney cancer that most often affects children ages 3 to 5, Cost and his co-researchers analyzed outcomes for 144 Colorado patients who had lymph node sampling at the time of surgery for kidney tumors between 20.
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That absence of data allowed a very small number of anecdotes to drive practice, but now we have more data showing that lymph node sampling is safe for patients, so we can look more at its therapeutic benefits beyond just the diagnostic benefits." "In my practice, I haven't seen complications from it, but there hadn't been much research looking at outcomes. "We've known that children who receive adequate lymph node sampling have better outcomes, but a longstanding hesitation has been, 'Is it safe to sample a larger number of lymph nodes?'" explains researcher Nicholas Cost, MD, an associate professor of urology in the University of Colorado Department of Surgery and CU Cancer Center member. However, recently published research shows that pediatric patients who receive more extended lymph node sampling during surgery for Wilms tumor, and other types of pediatric renal tumors, do not experience any more post-surgical complications than children who don't. While a growing body of evidence demonstrates that children who have extended lymph node sampling during surgery experience better outcomes, some have questioned whether removing more lymph nodes as part of the cancer staging is worth the risk of side effects such as lymphatic fluid leakage into the abdomen.