Robotic pelvic lymph node dissection for rectal cancer

Excerpt

Lateral lymph nodes are involved approximately in 10–25% of patients with rectal cancer [1]; however, routine lateral pelvic lymph node dissection (LPLND) has not been shown to improve 5-year overall or disease-free survival [2]. Whilst in Japan, it is indicated for patients with T3–T4 rectal cancers [1], in Europe chemoradiotherapy is the modality of choice for treating lateral pelvic nodes. Lateral pelvic lymph node dissection is not a routine practice in most surgical centres in Europe. There is a belief that metastasis to lateral nodes suggest systemic disease and hence should be treated with chemoradiation. However, in selected patients the use of pelvic radiotherapy can be avoided by offering surgical excision of lateral nodes [3]. …