Neoadjuvant (chemo)radiotherapy and Lateral Node Dissection: Is It Mutually Exclusive?
chemoradiotherapy
lateral lymph node
lateral lymph node dissection
radiotherapy
rectal cancer
Journal
Clinics in colon and rectal surgery
ISSN: 1531-0043
Titre abrégé: Clin Colon Rectal Surg
Pays: United States
ID NLM: 101084157
Informations de publication
Date de publication:
Nov 2020
Nov 2020
Historique:
entrez:
9
11
2020
pubmed:
10
11
2020
medline:
10
11
2020
Statut:
ppublish
Résumé
The importance of total mesorectal excision (TME) has been the global standard of care in patients with rectal cancer. However, there is no universal strategy for lateral lymph nodes (LLN). The treatment of the lateral compartment remains controversial and has gone to the opposite directions between Eastern and Western countries in the past decades. In the East, mainly Japan, surgeons consider LLN metastases as regional disease and have performed TME with lateral lymph node dissection (LLND) without neoadjuvant (chemo)radiotherapy ([C]RT) in patients with clinical Stage II/III rectal cancer below the peritoneal reflection. In the West, neoadjuvant radiotherapy or has been the standard, and surgeons do not perform LLND assuming the (C)RT can sterilize most lateral lymph node metastasis (LLNM). Recent evidences show that lateral nodes are the major cause of local recurrence after (C)RT plus TME, and LLND reduces local recurrence particularly from the lateral compartment. Probably a combination of the two strategies, that is, neoadjuvant (C)RT plus LLND, would be needed to improve outcomes in patients with lateral nodal disease.
Identifiants
pubmed: 33162839
doi: 10.1055/s-0040-1714239
pii: 01029
pmc: PMC7605909
doi:
Types de publication
Journal Article
Review
Langues
eng
Pagination
355-360Informations de copyright
Thieme. All rights reserved.
Déclaration de conflit d'intérêts
Conflict of Interest None.
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