Oncological outcomes of robotic-assisted laparoscopic versus open lateral lymph node dissection for locally advanced low rectal cancer

2018 ◽  
Vol 32 (11) ◽  
pp. 4498-4505 ◽  
Author(s):  
Tomohiro Yamaguchi ◽  
Yusuke Kinugasa ◽  
Akio Shiomi ◽  
Hiroyasu Kagawa ◽  
Yushi Yamakawa ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Lymph Node ◽  
Lymph Node Dissection ◽  
Locally Advanced ◽  
Low Rectal Cancer ◽  
Lateral Lymph Node Dissection ◽  
Node Dissection ◽  
Lateral Lymph Node ◽  
Robotic Assisted ◽  
Oncological Outcomes

Laparoscopic Versus Open Lateral Lymph Node Dissection for Locally Advanced Low Rectal Cancer

2017 ◽  
Vol 60 (9) ◽  
pp. 954-964 ◽  
Author(s):  
Tomohiro Yamaguchi ◽  
Tsuyoshi Konishi ◽  
Yusuke Kinugasa ◽  
Seiichiro Yamamoto ◽  
Takashi Akiyoshi ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Lymph Node ◽  
Lymph Node Dissection ◽  
Locally Advanced ◽  
Low Rectal Cancer ◽  
Lateral Lymph Node Dissection ◽  
Node Dissection ◽  
Lateral Lymph Node

scholarly journals Metastasis to lateral lymph nodes with no mesenteric lymph node involvement in low rectal cancer: a retrospective case series

2020 ◽  
Author(s):  
Peng Li ◽  
Zhichun Zhang ◽  
Yuanda Zhou ◽  
Qingsheng Zeng ◽  
Xipeng Zhang ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Lymph Node ◽  
Lymph Nodes ◽  
Lymph Node Dissection ◽  
Low Rectal Cancer ◽  
Lateral Lymph Node Dissection ◽  
Node Dissection ◽  
Mesenteric Lymph Nodes ◽  
Lateral Lymph Node ◽  
Mesenteric Lymph

Abstract Purpose The aim of this study is to examine the pattern of lymph node metastasis (lateral vs. mesenteric lymph nodes) in low rectal cancer.Methods This retrospective analysis included all patients undergoing laparoscopic total mesorectal excision plus lateral lymph node dissection for advanced low rectal cancer (up to 8 cm from the anal verge) during a period from July 1, 2017 to August 31, 2019 at the Department of Colorectal Surgery, Tianjin Union Medical Center. The decision to conduct lateral lymph node dissection was based on positive findings in preoperative imaging assessments.Results A total of 42 patients were included in data analysis. Surgery was successfully completed as planned, without conversion to open surgery in any case. A minimal of 10 mesenteric lymph nodes and 1 lateral lymph node on each side were dissected in all patients. Pathologic examination of resected specimens showed no metastasis to either mesenteric or lateral lymph nodes in 7 (16.7%) case, metastasis to both mesenteric and lateral lymph nodes in 26 (61.9%) cases, metastasis to mesenteric but not lateral lymph nodes in 4 (9.5%) cases, and metastasis to lateral but not mesenteric lymph nodes in 5 (11.9%) cases (n=2 in the obturator region; n=3 in the iliac artery region).Conclusion A clinically significant proportion of low rectal cancer patients have metastasis to lateral lymph nodes without involvement of mesenteric lymph nodes. More carefully planned prospective studies are needed to verify this preliminary finding.

Lateral lymph node dissection after neoadjuvant (chemo)radiotherapy may improve oncological outcomes in Western patients with low rectal cancer.

2020 ◽  
Vol 38 (4_suppl) ◽  
pp. 163-163 ◽  
Author(s):  
Hidde Maarten Kroon ◽  
Songphol Malakorn ◽  
Nagendra N Dudi-Venkata ◽  
Sergei Bedrikovetski ◽  
Jianliang Liu ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Lymph Node ◽  
Adjuvant Chemotherapy ◽  
Lymph Node Dissection ◽  
Local Recurrence Rate ◽  
Lateral Lymph Node Dissection ◽  
Short Axis ◽  
Node Dissection ◽  
Lateral Lymph Node ◽  
Oncological Outcomes

163 Background: In the West, rectal cancer patients with pre-treatment abnormal lateral lymph nodes (LLN) are commonly treated with neoadjuvant (chemo)radiotherapy (n(C)RT) followed by total mesorectal excision (TME). Few centers perform lateral lymph node dissection (LLND) in addition to this, with the aim of improving oncological outcomes. To date, no comparative data are available in Western patients. Methods: An international multi-center cohort study was conducted comparing six centers from the Netherlands and Australia treating patients with abnormal LLN (≥5mm short-axis) with n(C)RT and TME (LLND- group) versus similarly staged patients from a dedicated cancer center in the USA who underwent a LLND in addition to n(C)RT and TME (LLND+ group). Results: Data were available on 169 patients. LLND+ patients (n = 44) consisted of significantly younger and more female patients with higher ASA-scores and ypN-stages compared to LLND- patients (n = 115). LLND+ patients also had a larger median LLN short-axis and were more likely to receive adjuvant chemotherapy (100 vs. 30%; p < 0.0001). Between groups, the lateral local recurrence rate (LLRR) was 0% for LLND+ vs. 7% for LLND- (p = 0.09) and the local recurrence rate (LRR) was 3% for LLND+ vs. 11% for LLND- (p = 0.13). No significant differences were observed in disease-free survival (DFS, p = 0.94) or overall survival (OS, p = 0.42). Sub-analysis of patients who underwent adjuvant chemotherapy (LLND- patients: n = 35) demonstrated clinically relevant though non-statistically significant trends towards a lower LLRR (0% for LLND+ vs. 6% for LLND-; p = 0.07), LRR (3% for LLND+ vs. 14% for LLND-; p = 0.06), DFS (p = 0.19) and OS (p = 0.17) in favour of the LLND+ group. Conclusions: Lateral lymph node dissection in addition to neoadjuvant (chemo)radiotherapy may improve oncological outcomes in Western patients with low rectal cancer and abnormal lateral lymph nodes.

scholarly journals Lateral lymph node dissection for mid-to-low rectal cancer: is it safe and effective in a practice-based cohort?

BMC Surgery ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Masakatsu Numata ◽  
Hiroshi Tamagawa ◽  
Keisuke Kazama ◽  
Shinnosuke Kawahara ◽  
Sho Sawazaki ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Lymph Node ◽  
Lymph Node Dissection ◽  
Outcome Evaluation ◽  
Low Rectal Cancer ◽  
Lateral Lymph Node Dissection ◽  
Node Dissection ◽  
Mesorectal Excision ◽  
Lateral Lymph Node ◽  
R1 Resection

Abstract Background Most evidence regarding lateral lymph node dissection for rectal cancer is from expert settings. This study aimed to evaluate the safety and efficacy of this procedure in a practice-based cohort. Methods A total of 383 patients who were diagnosed with stage II–III mid-to-low rectal cancer between 2010 and 2019 and underwent primary resection with curative intent at a general surgery unit were retrospectively reviewed. After propensity matching, 144 patients were divided into the following groups for short- and long-term outcome evaluation: mesorectal excision with lateral lymph node dissection (n = 72) and mesorectal excision (n = 72). Results This practice-based cohort was characterized by a high pT4 (41.6%) and R1 resection (10.4%) rate. Although the operative time was longer in the lateral dissection group (349 min vs. 237 min, p < 0.001), postoperative complications (19.4% vs. 16.7%, p = 0.829), and hospital stay (18 days vs. 22 days, p = 0.059) did not significantly differ; 5-year relapse-free survival (62.5% vs. 66.4%, p = 0.378), and cumulative local recurrence (9.7% vs. 15.3%, p = 0.451) were also in the same range in both groups. In the seven locally recurrent cases in the lateral dissection group, four had undergone R1 resection. Conclusions Lateral lymph node dissection was found to be safe in this practice-based cohort; however, the local control effect was not obvious. To maximize the potential merits of lateral lymph node dissection, strategies need to be urgently established to avoid R1 resection in clinical practice.

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