Lymph node dissection (LND) does not appear to have a therapeutic benefit in patients with metastatic or non-metastatic renal cell carcinoma, according to a meta-analysis of 51 studies. Among the findings:

• LND was not linked with all-cause mortality in patients with either metastatic or non-metastatic disease.
• LND was not linked with improved oncologic outcomes in 3 studies that looked at non-metastatic subgroups at high risk of modal metastasis.
• Results were inconsistent when examining the link between LND extent and survival.
• A small number of patients with pN1 non-metastatic disease achieved 10-year cancer-specific survival ranging between 21% and 31%.
• Nodal involvement was independently linked with adverse prognosis in patients with either metastatic or non-metastatic disease.