ArticleJournal of clinical oncology : official journal of the American Society of Clinical Oncology2019
Neoadjuvant (Chemo)radiotherapy With Total Mesorectal Excision Only Is Not Sufficient to Prevent Lateral Local Recurrence in Enlarged Nodes: Results of the Multicenter Lateral Node Study of Patients With Low cT3/4 Rectal Cancer.
Article in Journal of clinical oncology : official journal of the American Society of Clinical Oncology, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 271 papers, 14 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Lateral Nodal Recurrence in Rectal Cancer
Snapshot Rectumcarcinoom 2016
Who cites it
271 citing papers in PubMed, 14 syntheses or guidelines pooled it, 492 citations in OpenAlex.
- Evidence Gap in Managing Lateral Pelvic Lymph Nodes in Rectal Cancer: a Systematic Review of Radiation Boost Strategies.Journal of gastrointestinal cancer · 2026Pooled it
- The Korean Rectal Cancer Multidisciplinary Committee Clinical Practice Guidelines for Rectal Cancer version 2.0.Annals of coloproctology · 2026Guideline
- Japanese Society for Cancer of the Colon and Rectum (JSCCR) guidelines 2024 for the treatment of colorectal cancer.International journal of clinical oncology · 2025Guideline
- Learning curve for lateral lymph node dissection in rectal cancer - a systematic review of literature.Techniques in coloproctology · 2025Pooled it
- Diagnostic performance of magnetic resonance imaging for lateral pelvic lymph node metastasis in patients with rectal carcinoma: a meta-analysis and systematic review.Diagnostic and interventional radiology (Ankara, Turkey) · 2025Pooled it
- [Evidence for the extent and oncological benefits of lymphadenectomy in colon and rectal cancer : A narrative review based on meta-analyses].Chirurgie (Heidelberg, Germany) · 2025Pooled it
- Robotic-assisted versus laparoscopic-assisted extended mesorectal excision: a comprehensive meta-analysis and systematic review of perioperative and long-term outcomes.Surgical endoscopy · 2024Pooled it
- Outcomes of robotic versus laparoscopic-assisted surgery in patients with rectal cancer: a systematic review and meta-analysis.Langenbeck's archives of surgery · 2024Pooled it
- Prognostic value of lateral lymph node metastasis in pretreatment MRI for rectal cancer in patients undergoing neoadjuvant chemoradiation followed by surgical resection without lateral lymph node dissection: A systemic review and meta-analysis.European journal of radiology · 2024Pooled it
- Efficacy and safety of PD-1/PD-L1 and CTLA-4 immune checkpoint inhibitors in the treatment of advanced colorectal cancer: a systematic review and meta-analysis.Frontiers in immunology · 2024Pooled it
- Pooled it
- Robotic pelvic side-wall lymph node dissection for rectal cancer: a systematic review of videos and application of the IDEAL 2A framework.Journal of robotic surgery · 2023Pooled it
- Risk factors for lateral pelvic lymph node metastasis in patients with lower rectal cancer: a systematic review and meta-analysis.Frontiers in oncology · 2023Pooled it
- Functional outcomes after lateral pelvic lymph node dissection for rectal cancer: a systematic review and meta-analysis.International journal of colorectal disease · 2022Pooled it
- Preoperative MRI assessment of rectal cancer for predicting metastasis-free survival-a post hoc analysis of a randomized controlled clinical trial.European radiology · 2026Trial
- Association of Lateral Pelvic Lymph Nodes with Disease Recurrence and Organ Preservation in Patients with Distal Rectal Adenocarcinoma Treated with Total Neoadjuvant Therapy.Annals of surgery · 2025Trial
- Evaluation of Nursing Effects of Pelvic Floor Muscle Rehabilitation Exercise on Gastrointestinal Tract Rectal Cancer Patients Receiving Anus-preserving Operation by Intelligent Algorithm-based Magnetic Resonance Imaging.Contrast media & molecular imaging · 2022Trial
- Correspondence: Radiation Boost to Lateral Pelvic Nodes in Rectal Cancer: Promising is not yet Proven.Journal of gastrointestinal cancer · 2026Article
- Lateral pelvic lymph nodes in rectal cancer: a narrative review.Abdominal radiology (New York) · 2026Review
- Temporal lymph node imaging features for prognostic risk stratification in neoadjuvant immunotherapy for esophageal cancer: a multicenter study.European radiology · 2026Article
211 more citing papers are in PubMed but not listed here.
Corrections and comments
- Commented on by
- Commented on by
Authors and funding
16 authors at 11 institutions in 7 countries.
Funding
Abstract
purposeImprovements in magnetic resonance imaging (MRI), total mesorectal excision (TME) surgery, and the use of (chemo)radiotherapy ([C]RT) have improved local control of rectal cancer; however, we have been unable to eradicate local recurrence (LR). Even in the face of TME and negative resection margins (R0), a significant proportion of patients with enlarged lateral lymph nodes (LLNs) suffer from lateral LR (LLR). Japanese studies suggest that the addition of an LLN dissection (LLND) could reduce LLR. This multicenter pooled analysis aims to ascertain whether LLNs actually pose a problem and whether LLND results in fewer LLRs. PATIENTS AND
methodsData from 1,216 consecutive patients with cT3/T4 rectal cancers up to 8 cm from the anal verge who underwent surgery in a 5-year period were collected. LLND was performed in 142 patients (12%). MRIs were re-evaluated with a standardized protocol to assess LLN features.
resultsOn pretreatment MRI, 703 patients (58%) had visible LLN, and 192 (16%) had a short axis of at least 7 mm. One hundred eight patients developed LR (5-year LR rate, 10.0%), of which 59 (54%) were LLRs (5-year LLR rate, 5.5%). After multivariable analyses, LLNs with a short axis of at least 7 mm resulted in a significantly higher risk of LLR (hazard ratio, 2.060; P = .045) compared with LLNs of less than 7 mm. In patients with LLNs at least 7 mm, (C)RT plus TME plus LLND resulted in a 5-year LLR of 5.7%, which was significantly lower than that in patients who underwent (C)RT plus TME (5-year LLR, 19.5%; P = .042).
conclusionLLR is still a significant problem after (C)RT plus TME in LLNs with a short axis at least 7 mm on pretreatment MRI. The addition of LLND results in a significantly lower LLR rate.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.