Scholarlink

Purpose <p>To identify when lateral lymph node dissection (LLND) can be omitted following neoadjuvant chemoradiotherapy (nCRT), for which patients it remains imperative, and the preoperative risk factors for recurrence post-nCRT.</p> Methods <p>We analyzed the clinical and pathological factors, surgical and recurrence details, and survival rates of 61 patients with lower rectal cancer, who underwent curative resection following nCRT between July, 2013 and August, 2024.</p> Results <p>LLND was omitted for 42 patients without suspected lateral lymph node metastasis, with no recurrence in lateral lymph node regions. Lymph node metastasis was confirmed in 8 (42.1%) of 19 patients who underwent LLND, all of whom had lateral lymph node enlargement (short-axis diameter ≥ 7&#xa0;mm) identified prior to nCRT. One patient had recurrence in the LLND area. The 3-year disease-free and overall survival rates were 70.0% and 91.5%, respectively, with higher local recurrence in the LLND group (24.7%) than in the omission group (6.9%). Extramural vascular invasion was an independent prognostic factor for disease-free survival (<i>p</i> = 0.025), with early postoperative pulmonary metastases identified in 6 of 13 patients.</p> Conclusions <p>Selectively omitting LLND may be feasible following nCRT, especially for patients without persistent lateral lymph node enlargement. Extramural vascular invasion is strongly associated with distant metastasis, potentially necessitating additional systemic treatments.</p>

错误：搜索内容不能为空，请输入英文关键词
错误：关键词超出字数限制，请精简
高级检索

Predictors of distant recurrence and the role of selective lateral lymph node dissection after preoperative chemoradiotherapy for rectal cancer: a retrospective study

  • 期刊论文

  • 发表日期：

    2026年3月3日

查看全文
  • Takuya Shiraishi,
  • Chika Katayama,
  • Yuta Shibasaki,
  • Chika Komine,
  • Takuhisa Okada,
  • Akihiko Sano,
  • Makoto Sakai,
  • Hiroomi Ogawa,
  • Ken Shirabe,
  • Hiroshi Saeki

摘要

Purpose

To identify when lateral lymph node dissection (LLND) can be omitted following neoadjuvant chemoradiotherapy (nCRT), for which patients it remains imperative, and the preoperative risk factors for recurrence post-nCRT.

Methods

We analyzed the clinical and pathological factors, surgical and recurrence details, and survival rates of 61 patients with lower rectal cancer, who underwent curative resection following nCRT between July, 2013 and August, 2024.

Results

LLND was omitted for 42 patients without suspected lateral lymph node metastasis, with no recurrence in lateral lymph node regions. Lymph node metastasis was confirmed in 8 (42.1%) of 19 patients who underwent LLND, all of whom had lateral lymph node enlargement (short-axis diameter ≥ 7 mm) identified prior to nCRT. One patient had recurrence in the LLND area. The 3-year disease-free and overall survival rates were 70.0% and 91.5%, respectively, with higher local recurrence in the LLND group (24.7%) than in the omission group (6.9%). Extramural vascular invasion was an independent prognostic factor for disease-free survival (p = 0.025), with early postoperative pulmonary metastases identified in 6 of 13 patients.

Conclusions

Selectively omitting LLND may be feasible following nCRT, especially for patients without persistent lateral lymph node enlargement. Extramural vascular invasion is strongly associated with distant metastasis, potentially necessitating additional systemic treatments.