Correction of tumor stage is required not
only in relation to T stage, but in case of N stage (affection of regional lymph
nodes) as well. When hunter 4025-graphy reveals two or more affected regional
lymph nodes (in this case size is not taken into account), their condition is
considered as N2, which automatically refers this patient to IV stage of renal
cancer. It is well known that affection of lymph nodes not always evidences
their metastatic affection, it may be a manifestation of follicular hyperplasia
and histiocytosis. Therefore in relation to N criterion we also applied
correction with consideration of data gathered after study of preparation
acquired during lymph node dissection. Affection of lymph nodes was revealed in
24 of 143 renal cance patients before surgery, but metastatic affection was
confirmed by SEA in 6 (25%) of them only. At the same time micrometastases of
renal cancer in lymph nodes are revealed in 8 patients, who, prior to surgery,
were considered as patients without lymphogenous metastases. Percentage of
confirmed lymphogenous metastasing among 143 patients was 9.8%. 57% of all
metastases into lymph nodes, detected by spectral-entropic analysis, were
microscopic. It is one of the pro-arguments for mandatory application of
extended lymphadenectomy during surgery because of lesser renal tumor,
irrespective of its character (organ-preserving or organ-removing).
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