Five-year results of abdominopelvic lymph node dissection for carcinoma of the rectum

Stearns, Maus W.; Deddish, Michael R.

doi:10.1007/bf02616711

Cited by 189 publications

(65 citation statements)

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“…Although lateral pelvic dissection has been performed since the early 1950s, 24 -26 it has not been held in high regard in Western countries. The negative feelings about this technique may be based on the results of studies reporting a lack of significant prognostic improvement between patients undergoing and those not undergoing lateral dissection, 5,7,27,28 and it is often concluded that lateral metastases predominantly reflect systemic spread rather than regional disease. 17 Although the question of whether lateral involvement means regional or systemic disease should be answered only by estimating the prognoses of patients with actual lateral involvement who received thorough lateral dissection, few reports have addressed this matter.…”

Section: Discussionmentioning

confidence: 99%

“…4 In the TNM classification, a lateral lymph node is defined as nonregional for rectal cancer, and it has been widely accepted since the 1950s that the survival rate of patients with lateral involvement is unfavorable. [5][6][7] The incidence of lateral cancer spread in patients with lower rectal cancer has been reported as 10% to 25%. 6,8 Further, occult metastases are present in approximately 4% of patients who, based on conventional histologic examination, are negative for lateral node involvement.…”

Section: Discussionmentioning

confidence: 99%

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Prognostic Determinants of Patients With Lateral Nodal Involvement by Rectal Cancer

Ueno¹,

Mochizuki²,

Hashiguchi³

et al. 2001

Annals of Surgery

112

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ObjectiveTo clarify the characteristics related to long-term survival in patients with lateral nodal involvement. Summary Background DataFew reports have addressed the prognostic determinants in patients with actual lateral nodal involvement, which are important in determining treatment. MethodsReview of a prospective colorectal database at a single institution for a 10-year period (1987)(1988)(1989)(1990)(1991)(1992)(1993)(1994)(1995)(1996) identified 53 patients with lateral nodal involvement. ResultsAll nine patients who underwent resection of synchronous distant metastases developed recurrence and died within 3 years. Of the 44 patients without distant metastases, 25 (57%) developed locoregional recurrence, and the overall 5-year survival rate was 32%. Multivariate analysis showed that age, total number of involved nodes (mesorectal and lateral), and circumferential surgical margin involvement had independently predicted postoperative survival. Patients with three or fewer nodes involved accounted for one third of lateral-positive patients, with a 5-year survival rate of 75%, whereas the 18 patients with four or more involved nodes had a 5-year survival rate of 4%. All eight patients with circumferential margin involvement died of carcinoma, and seven developed locoregional recurrences. Involvement of other pelvic organs had no effect on prognosis, nor were adverse prognostic outcomes noted by the region of lateral involvement.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Prognostic Determinants of Patients With Lateral Nodal Involvement by Rectal Cancer

Ueno¹,

Mochizuki²,

Hashiguchi³

et al. 2001

Annals of Surgery

112

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“…In the United States, extended LN dissection in rectal cancer was done in the 1950s, but the effectiveness of lateral pelvic LN dissection was not accepted because it led to an increase in blood loss, and urinary and sexual dysfunctions without further survival benefit (15). Preoperative radiotherapy reduced the relative risk of local recurrence, although without significant survival improvement (16,17).…”

Section: Rectal Cancermentioning

confidence: 99%

Significance and Mechanism of Lymph Node Metastasis in Cancer Progression

Kawada

Taketo²

2011

Cancer Research

143

114

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The effect of local therapy, such as surgical lymph node (LN) dissection and radiotherapy, on the survival of cancer patients has been debated for decades. Several lines of recent clinical evidence support that LN metastasis plays significant roles in systemic dissemination of cancer cells, although the effects of surgical LN dissection on survival was downplayed historically because of controversial data. Molecular studies of LN metastasis suggest that the microenvironment within LNs, including chemokines and lymphangiogenesis, can mediate the metastatic spread to the sentinel LNs, and beyond. It has been shown that chemokine receptor CXCR3 is involved in LN metastasis, and its inhibition may improve patient prognosis. Although it remains to be determined whether local therapy is best pursued through LN dissection or through a combination of resection with radiation, prevention of regional metastases is an important goal in the treatment of cancer patients to achieve a better survival. Cancer Res; 71(4); 1214-8. Ó2011 AACR.

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“…These observations of lymph node metastasis of a prostatic adenocarcinoma in the mesorectum show that a lymphatic connection could exist between hypogastric lymphatic drainage and mesorectal drainage. Actually, an extension of a rectal adenocarcinoma to extra-mesenteric lymph nodes was documented many years previously (8). Therefore, lateral node dissection has been advocated, even for advanced rectal carcinoma, at or below the peritoneal reflection (9).…”

Section: Discussionmentioning

confidence: 99%

Lymph Node Metastases of Prostatic Adenocarcinoma in the Mesorectum in Patients with Rectal Cancer

Park

Kim

et al. 2005

Cancer Res Treat

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Five-year results of abdominopelvic lymph node dissection for carcinoma of the rectum

Cited by 189 publications

References 0 publications

Prognostic Determinants of Patients With Lateral Nodal Involvement by Rectal Cancer

Prognostic Determinants of Patients With Lateral Nodal Involvement by Rectal Cancer

Significance and Mechanism of Lymph Node Metastasis in Cancer Progression

Lymph Node Metastases of Prostatic Adenocarcinoma in the Mesorectum in Patients with Rectal Cancer

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