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International Journal of Colorectal Disease

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01-06-2021 | Rectal Cancer | Original Article

Effective dissection for rectal cancer with lateral lymph node metastasis based on prognostic factors and recurrence type

Authors: Hajime Morohashi, Yoshiyuki Sakamoto, Takuya Miura, Daichi Ichinohe, Kotaro Umemura, Takanobu Akaishi, Kentaro Sato, Daisuke Kuwata, Keisuke Yamazaki, Taiichi Wakiya, Kenichi Hakamada

Published in: International Journal of Colorectal Disease | Issue 6/2021

Abstract

Purpose

There are no reports showing the significance and effective range of dissection for patients with lateral lymph node metastasis (LLNM). This study aimed to investigate the indications for lateral lymph node dissection (LLND) in patients with LLNM based on prognostic factors and recurrence types.

Methods

We reviewed 379 patients with advanced rectal cancer who were treated with total mesorectal excision plus LLND. We analyzed background factors and survival times of patients who had LLNM to determine prognostic factors and recurrence types.

Results

Pathological LLNM occurred in 44 (11.6%). Among patients with LLNM, the predictors of poor prognoses, according to univariate analysis, were > 3 node metastases, the presence of node metastasis on both sides, and spreading beyond the internal iliac lymph nodes. Moreover, LLNM beyond the internal iliac region was found to be an independent prognostic risk factor. Twenty-eight of the 44 patients with lateral lymph node metastasis (64%) relapsed, 22 of whom had distant metastases and 11 of whom experienced local recurrences. Among the latter group, nine (20%) and two (5%) had recurrences in the central and lateral pelvis, respectively.

Conclusion

The therapeutic benefit of resection was high, especially in patients with ≤ 3 positive lateral lymph nodes, one-sided bilateral lymph node areas, and positive nodes localized near the internal iliac artery.

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Title: Effective dissection for rectal cancer with lateral lymph node metastasis based on prognostic factors and recurrence type
Authors: Hajime Morohashi
Yoshiyuki Sakamoto
Takuya Miura
Daichi Ichinohe
Kotaro Umemura
Takanobu Akaishi
Kentaro Sato
Daisuke Kuwata
Keisuke Yamazaki
Taiichi Wakiya
Kenichi Hakamada
Publication date: 01-06-2021
Publisher: Springer Berlin Heidelberg
Keywords: Rectal Cancer
Metastasis
Rectal Cancer
Published in: International Journal of Colorectal Disease / Issue 6/2021
Print ISSN: 0179-1958
Electronic ISSN: 1432-1262
DOI: https://doi.org/10.1007/s00384-021-03870-5

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Effective dissection for rectal cancer with lateral lymph node metastasis based on prognostic factors and recurrence type

Abstract

Purpose

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

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