Management of lateral pelvic lymph nodes in rectal cancer

Chang, Gloria; Halabi, Wissam J.; Ali, Fadwa

doi:10.1002/jso.27317

Cited by 4 publications

(3 citation statements)

References 61 publications

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“…More recently, the colorectal community in Western Europe has driven attention to the importance of lateral pelvic lymph node involvement, mainly in distal rectal tumors 15 . Patients with locally advanced rectal cancers (LARC) who present enlarged lateral pelvic lymph nodes (>5 mm in their shortest axis) after neoadjuvant chemoradiotherapy should undergo lateral pelvic lymphadenectomy.…”

Section: Clinical Presentation and Initial Evaluationmentioning

confidence: 99%

Current guidelines for the management of rectal cancer patients: a review of recent advances and strategies

Martinez,

Campos

2024

Rev. Assoc. Med. Bras.

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Section: Clinical Presentation and Initial Evaluationmentioning

confidence: 99%

Current guidelines for the management of rectal cancer patients: a review of recent advances and strategies

Martinez,

Campos

2024

Rev. Assoc. Med. Bras.

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“…The outer extension encompasses the obturator artery and pelvic wall (along the inner edge of the psoas major muscle and obturator internus muscle). Posteriorly, they extend toward the sciatic nerve and piriformis muscle [ 9 – 14 ] (Fig. 1 ).…”

Section: Definition Of Internal Iliac and Obturator Regionsmentioning

confidence: 99%

Management of internal iliac and obturator lymph nodes in mid-low rectal cancer

Xiao,

Chen,

Liu

2024

World J Surg Onc

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In rectal cancer treatment, the diagnosis and management of lateral pelvic lymph nodes (LLN) are critical for preventing local recurrence. Over time, scholars have reached a consensus: when imaging suggests LLN metastasis, combining neoadjuvant chemoradiotherapy (nCRT) with selective LLN dissection (LLND) can mitigate the risk of recurrence. Selective LLND typically encompasses lymph nodes in the internal iliac and obturator regions. Recent studies emphasize distinctions between internal iliac and obturator lymph nodes regarding prognosis and treatment outcomes, prompting the need for differentiated diagnostic and treatment approaches.

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“…This finding was further evaluated with more cadaveric studies, which demonstrated that lateral pelvic lymph nodes (LPLNs) are mainly distributed to the internal iliac and obturator spaces [ 2 ]. These spaces shape a triangle on the lateral side of the pelvis, whose boundaries are the external iliac artery laterally, the ureter medially, and the urinary bladder caudally [ 3 ]. On the basis of the findings of different studies, the incidence of LPLN metastasis from low rectal cancer is approximately 15% [ 4 ].…”

Section: Introductionmentioning

confidence: 99%

The use of indocyanine green for lateral lymph node dissection in rectal cancer—preliminary data from an emerging procedure: a systematic review of the literature

Kehagias,

Lampropoulos,

Bellou

et al. 2024

Tech Coloproctol

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Introduction Lateral lymph node dissection (LLND) for rectal cancer is still not a widely established technique owing to the existing controversy between Eastern and Western countries and the lack of well-designed studies. The risk of complications and the paucity of long-term oncological results are significant drawbacks for further applying this technique. The use of indocyanine green (ICG) near-infrared (NIR) fluorescence for LLND appears as a promising technique for enhancing postoperative and oncological outcomes. This review aims to evaluate the emerging role of ICG during LLND and present the benefits of its application. Materials and methods Systematic electronic research was conducted in PubMed and Google Scholar using a combination of medical subject headings (MeSH). Studies presenting the use of ICG during LLND, especially in terms of harvested lymph nodes, were included and reviewed. Studies comparing LLND with ICG (LLND + ICG) or without ICG (LLND-alone) were further analyzed for the number of lymph nodes and postoperative outcomes. Results In total, 13 studies were found eligible and analyzed for different parameters. LLND + ICG is associated with significantly increased number of harvested lateral lymph nodes (p < 0.05), minor blood loss, decreased operative time, and probably decreased urinary retention postoperatively compared with LLND-alone. Conclusions The use of ICG fluorescence during LLND is a safe and feasible technique for balancing postoperative outcomes and the number of harvested lymph nodes. Well-designed studies with long-term results are required to elucidate the oncological benefits and establish this promising technique.

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Management of lateral pelvic lymph nodes in rectal cancer

Cited by 4 publications

References 61 publications

Current guidelines for the management of rectal cancer patients: a review of recent advances and strategies

Current guidelines for the management of rectal cancer patients: a review of recent advances and strategies

Management of internal iliac and obturator lymph nodes in mid-low rectal cancer

The use of indocyanine green for lateral lymph node dissection in rectal cancer—preliminary data from an emerging procedure: a systematic review of the literature

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