When you have a partial nephrectomy for stage 1 grade 3 clear cell kidney cancer, how can you tell if the lymph nodes are clear?

No lymph node spread: Stage I means, no lymph node spread, by pre operative evaluation, partial nephrectomy usually done for selective small tumors upto 4 cm or has less post operative incidence of non cancer deaths

CT scan : Generally, cancerous lymph nodes are seen radiographically although it is possible to have cancer in normal sized (by ct) nodes. Also, smaller (lower risk tumors) are less associated with lymphatic involvement. Lymph node removal is generally not likely to improve survival in most cases of kidney cancer (renal cell ca). It is not usual practice to remove nodes at partial nephrectomy.

Only Time Will Tell: Usually, lymph nodes are not removed at the time of partial nephrectomy, unless suspicious on pre-op imaging. Post-op imaging surveillance will be necessary to watch for recurrence. If no nodal enlargement is observed over the following years, then the nodes are not involved.