Lymph node (LN) involvement (LNI) occurs in 30–40 % of patients with renal cell carcinoma (RCC) [1] and is an independent factor of poor prognosis for both advanced RCC and metastatic RCC [2,3]. Once LNI is identified, lymph node dissection (LND) or advanced treatment, including adjuvant therapy, is needed [4]. The American Urological Association and European Association of Urology have recommended LND with nephrectomy when clinically enlarged LNs are present for staging and prognostic assessmen…