Open AccessLateral pelvic lymph nodes for rectal cancer: A review of diagnosis and management
Author(s) -
Shimpei Ogawa,
Michio Itabashi,
Yoshio Inoue,
Takeshi Ohki,
Yoshiko Bamba,
Kurodo Koshino,
Ryōsuke Nakagawa,
Kimitaka Tani,
Hisako Aihara,
Hiroka Kondo,
Shigeki Yamaguchi,
Masakazu Yamamoto
Publication year - 2021
Publication title -
world journal of gastrointestinal oncology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.924
H-Index - 26
ISSN - 1948-5204
DOI - 10.4251/wjgo.v13.i10.1412
Subject(s) - medicine , magnetic resonance imaging , radiology , colorectal cancer , metastasis , radiation therapy , pelvis , dissection (medical) , cancer
The current status and future prospects for diagnosis and treatment of lateral pelvic lymph node (LPLN) metastasis of rectal cancer are described in this review. Magnetic resonance imaging (MRI) is recommended for the diagnosis of LPLN metastasis. A LPLN-positive status on MRI is a strong risk factor for metastasis, and evaluation by MRI is important for deciding treatment strategy. LPLN dissection (LPLD) has an advantage of reducing recurrence in the lateral pelvis but also has a disadvantage of complications; therefore, LPLD may not be appropriate for cases that are less likely to have LPLN metastasis. Radiation therapy (RT) and chemoradiation therapy (CRT) have limited effects in cases with suspected LPLN metastasis, but a combination of preoperative CRT and LPLD may improve the treatment outcome. Thus, RT and CRT plus selective LPLD may be a rational strategy to omit unnecessary LPLD and produce a favorable treatment outcome.