The Role of Lateral Lymph Node Dissection in the Management of Lower Rectal Cancer

Overview

Journal Langenbecks Arch Surg

Specialty General Surgery

Date 2011 Nov 23

PMID 22105772

Citations 7

Authors

Ziting Wang

Kep Yong Loh

Kok-Yang Tan

Emile Chung-Hou Woo

Affiliations

Soon will be listed here.

Abstract

Introduction: Lateral lymph node involvement is a problem encountered in patients with low rectal cancers. This has been documented in both anatomical and pathological studies. Currently, the vast majority of centers have concentrated on the use of chemoradiation to obtain better local control and manage these nodes indirectly. In Japan, extended nodal dissection for the control of pelvic nodal disease has seen further advancement. This paper discusses the key issues involved in the management of pelvic lateral nodes in low rectal cancers.

Methods: A review of available literature and critical appraisal of the entity of lateral nodes in low rectal cancers, the treatment options, and oncological and functional results were performed.

Results: There are good data showing that the entity of pelvic lateral nodes in low rectal cancers should not be ignored. Recent data have emerged showing that radiotherapy is associated with significant long-term functional side effects. Refinement of the technique, lateral node dissection, has led to good local control as well as good functional outcomes.

Conclusion: In this context, there needs to be a reevaluation of the role of chemoradiation as the sole treatment for lateral nodal disease in centers outside of Japan. Individualization of the treatment of rectal cancer may require all centers to be able to offer both modalities.

Citing Articles

Lateral pelvic sentinel lymph node biopsy using indocyanine green fluorescence navigation: can it be a powerful supplement tool for predicting the status of lateral pelvic lymph nodes in advanced lower rectal cancer.

Su H, Xu Z, Bao M, Luo S, Liang J, Pei W Surg Endosc. 2023; 37(5):4088-4096.

PMID: 36997652 DOI: 10.1007/s00464-023-10033-w.

Lateral pelvic lymph nodes for rectal cancer: A review of diagnosis and management.

Ogawa S, Itabashi M, Inoue Y, Ohki T, Bamba Y, Koshino K World J Gastrointest Oncol. 2021; 13(10):1412-1424.

PMID: 34721774 PMC: 8529924. DOI: 10.4251/wjgo.v13.i10.1412.

Total mesorectal excision with and without lateral lymph node dissection: a systematic review of the literature.

Longchamp G, Meyer J, Christou N, Popeskou S, Roos E, Toso C Int J Colorectal Dis. 2020; 35(7):1183-1192.

PMID: 32458399 DOI: 10.1007/s00384-020-03623-w.

Lateral lymph node dissection for low rectal cancer: Is it necessary?.

Christou N, Meyer J, Toso C, Ris F, Buchs N World J Gastroenterol. 2019; 25(31):4294-4299.

PMID: 31496614 PMC: 6710187. DOI: 10.3748/wjg.v25.i31.4294.

Comparison of guidelines for the management of rectal cancer.

Luzietti E, Pellino G, Nikolaou S, Qiu S, Mills S, Warren O BJS Open. 2018; 2(6):433-451.

PMID: 30511044 PMC: 6254003. DOI: 10.1002/bjs5.88.

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