Current status of treatment for locally advanced middle-low rectal cancer with lateral lymph node metastasis
10.3760/cma.j.cn113030-20221124-00395
- VernacularTitle:侧方淋巴结转移的中低位局部晚期直肠癌治疗现状
- Author:
Chunying LI
1
;
Xin JI
;
Jinwei LUAN
;
Yang ZHOU
;
Jiaqi LI
;
Xianglan LI
Author Information
1. 哈尔滨医科大学附属肿瘤医院腹部放疗科，哈尔滨 150000
- Keywords:
Rectal neoplasms;
Lateral lymph node metastasis;
Neoadjuvant radiochemotherapy;
Lateral pelvic lymph node dissection;
Total mesorectal excision
- From:
Chinese Journal of Radiation Oncology
2023;32(12):1104-1108
- CountryChina
- Language:Chinese
-
Abstract:
The incidence of lateral lymph node metastases (LLN) of locally advanced middle-low rectal cancer (II-Ⅲ stage) is high and clinical prognosis is poor. At present, the treatment plan of LLN is controversial between the East and the West. Scholars from the East represented by Japan believe that LLN is a regional disease. Lateral pelvic lymph node dissection (LPLND) is recommended when the tumor is located under the peritoneal reflection and invades into the muscular layer, regardless of the presence or absence of LLN. However, European and American scholars believe that LLN is a systemic disease and recommend neoadjuvant chemoradiotherapy (nCRT) combined with total mesorectal excision (TME). Nevertheless, recent studies have found that neither nCRT nor LPLND can significantly reduce the locoregional recurrence (LR) rate in patients with LLN, while nCRT combined with LPLND yields better prognosis. Some studies have also demonstrated that increasing the radiotherapy dose of metastatic lymph nodes can improve the local control rate. In this article, current treatment status of this population was reviewed, aiming to provide a basis for clinical treatment.
