You have accessJournal of UrologyPediatric Urology I (PD15)1 Sep 2021PD15-09 EXTENDED LYMPH NODE SAMPLING DOES NOT LEAD TO INCREASED COMPLICATIONS IN CHILDREN WITH RENAL TUMORS Jonathan Walker, Daniel Han, Peter Boxley, Andrew Nicklawsky, Nina Mikkilineni, Sarah Hecht, Amanda Saltzman, and Nicholas Cost Jonathan WalkerJonathan Walker More articles by this author , Daniel HanDaniel Han More articles by this author , Peter BoxleyPeter Boxley More articles by this author , Andrew NicklawskyAndrew Nicklawsky More articles by this author , Nina MikkilineniNina Mikkilineni More articles by this author , Sarah HechtSarah Hecht More articles by this author , Amanda SaltzmanAmanda Saltzman More articles by this author , and Nicholas CostNicholas Cost More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000001997.09AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Children’s Oncology Group protocols mandate lymph node sampling (LNS) during surgery for suspected Wilms tumors, but the extent of LNS has not been clearly defined. While data suggest a minimum of 6 LNs are needed for accurate staging, LNS is often omitted or underperformed. Concerns over increased morbidity with extended LNS have led to hesitancy adopting a formal LN dissection template. The objective of this study is to determine the rate of complications during LNS in children undergoing oncologic renal extirpation. We hypothesized that complications in children would be rare and not differ based on the number of LNs sampled. METHODS: A retrospective review was performed including patients aged 0–18y undergoing extirpative renal surgery with LNS for a suspected malignancy at a tertiary institution between 2005-2019. Patients with an unknown number of LNs sampled or whose LNs were not sent as a separate specimen were excluded. Postoperative complications were categorized based on the Clavien-Dindo (CD) scale. A “clinically significant” complication was defined as any CD complication ≥III, small bowel obstruction (SBO)/ileus, chylous ascites, organ injury, or wound infection/abscess. Chi-square, Wilcoxon rank sum, and Fishers Exact tests were used to assess the relationship between patient characteristics and complications. Patients were separated into 2 cohorts for multivariable analysis (MVA) using a clinically relevant cut-point of ≤vs >6 LNs sampled. RESULTS: 150 patients met inclusion criteria. Median patient age was 37.8 months (IQR 20.3-62.4). 24 patients (16%) had a clinically significant complication, the most common of which was SBO/ileus (n=18). 7 (39%) of the SBO/ileus patients required surgical management. No CD grade IV or V complications were noted. There was no difference in overall complications, OR time, or length of stay between the two cohorts. On MVA, sampling >6 LNs was not predictive of having a clinically significant complication (p=0.958). CONCLUSIONS: More extensive LNS during surgery for pediatric renal tumors does not appear to lead to an increase in complications. A standardized LNS template for pediatric renal tumors to achieve a minimum LN yield may lead to more accurate staging without placing the patient at increased risk of morbidity. Source of Funding: University of Colorado Cancer Center Support Grant (P30CA046934) © 2021 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 206Issue Supplement 3September 2021Page: e275-e276 Advertisement Copyright & Permissions© 2021 by American Urological Association Education and Research, Inc.MetricsAuthor Information Jonathan Walker More articles by this author Daniel Han More articles by this author Peter Boxley More articles by this author Andrew Nicklawsky More articles by this author Nina Mikkilineni More articles by this author Sarah Hecht More articles by this author Amanda Saltzman More articles by this author Nicholas Cost More articles by this author Expand All Advertisement Loading ...