Concept of lateral lymph nodes in rectal cancer and controversy over lateral lymph node dissection.
10.3760/cma.j.cn441530-20220725-00326
- VernacularTitle:直肠癌侧方淋巴结的概念与侧方淋巴结清扫的争议
- Author:
Ke AN
1
;
Jin GU
2
Author Information
1. Department of Gastrointestinal Surgery, Peking University Shougang Hospital, Beijing 100144,China.
2. Department of Gastrointestinal Surgery, Peking University Shougang Hospital, Beijing 100144,China Department of Gastrointestinal Surgery III, Peking University Cancer Hospital & Institute, Beijing 100142, China.
- Publication Type:Multicenter Study
- MeSH:
Humans;
Lymph Node Excision/methods*;
Lymph Nodes/pathology*;
Lymphatic Metastasis/pathology*;
Neoadjuvant Therapy/methods*;
Neoplasm Recurrence, Local/surgery*;
Neoplasm Staging;
Rectal Neoplasms/therapy*;
Treatment Outcome
- From:
Chinese Journal of Gastrointestinal Surgery
2022;25(8):694-698
- CountryChina
- Language:Chinese
-
Abstract:
Lateral lymph node (LLN) metastasis in locally advanced rectal cancer (LARC) is associated with patient prognosis. However, the role of lateral lymph node dissection (LLND) remains controversial. The concept of LLN and the exact definition of LLND have been inconsistently reported in the literatures. The treatment strategy for LARC has differed between the East and the West. The Japanese doctors advocates total mesorectal excision (TME) with LLND for LARC, but less neoadjuvant radiochemotherapy (NARC). European and Americans prefer NARC plus TME, and do not recommend LLND. So far, only the Japanese Statute of Colorectal Cancer has a clear definition of the concept of LLN and LLND. The use of TME plus LLND for LARC is not supported by high level evidences. In today's high-speed development of minimally invasive surgery, the proper selection of standardized surgical methods for LARC requires the joint efforts of scholars from the East and the West to conduct multicenter high-grade clinical trials to select the best treatment option for patients with LARC.
