Nature of regional lymphogenous metastatic spreading in rectum carcinoma

In the absence of visible damaged lymph nodes it is appropiate to supplement radical operation by expanded lymphadenectomy in following cases: 1) in localization of the tumor in anal and inferior- ampullar parts of the rectum; 2) in tumors growing through all the layers or beyond the rectum wall (T3 and T4 stages); 3) in endophitic type of the tumor growth; 4) in low-differential and mucinous adenocarcinomas; 5) in the tumor of size more than 5 sm2.