ArticleBMC cancer2022
Prognostic significance of lateral pelvic lymph node dissection for middle-low rectal cancer patients with lateral pelvic lymph node metastasis: a propensity score matching study.
Article in BMC cancer, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers.
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12 citing papers in PubMed, 15 citations in OpenAlex.
- Article
- Impact of primary tumor clinicopathological factors on prognosis after hepatic resection for rectal liver metastases.Annals of gastroenterological surgery · 2025Article
- Advancement of indocyanine green fluorescence imaging technology in laparoscopic surgery for rectal cancer.World journal of gastrointestinal surgery · 2025Review
- The oncologic benefits of lateral lymph node dissection after neoadjuvant therapy - local control or survival?Techniques in coloproctology · 2025Review
- Review
- Management of internal iliac and obturator lymph nodes in mid-low rectal cancer.World journal of surgical oncology · 2024Review
- Quality assessment of surgery for colorectal cancer: Where do we stand?World journal of gastrointestinal surgery · 2024Article
- Current perspectives on the management of lateral pelvic lymph nodes in rectal cancer.World journal of clinical oncology · 2023Review
- Global Status of Research on Lateral Lymph Nodes in Rectal Cancer from 1994 to 2022: A Bibliometric Analysis.Healthcare (Basel, Switzerland) · 2023Article
- Difference in prognostic impact of lateral pelvic lymph node metastasis between pre- and post-neoadjuvant chemoradiotherapy in rectal cancer patients.Annals of surgical treatment and research · 2023Article
- Optimization of treatment strategies based on preoperative imaging features and local recurrence areas for locally advanced lower rectal cancer after lateral pelvic lymph node dissection.Frontiers in oncology · 2023Article
- Distant Metastasis is the Dominant Cause of Treatment Failure after Lateral Lymph Node Dissection in Patients with Lateral Lymph Node Metastasis: Results of the Large Multicenter Lateral Node Study in China.Journal of Cancer · 2023Article
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5 authors at 1 institution in 1 country.
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Abstract
backgroundThere is still controversy regarding the clinical value and significance of lateral pelvic lymph node (LPN) dissection (LPND). The present study aimed to investigate whether the addition of LPND to total mesorectal excision (TME) confers survival benefits in rectal cancer patients with clinical lateral pelvic node metastasis (LPNM).
methodsFrom January 2015 to January 2021, a total of 141 rectal cancer patients with clinical evidence of LPNM who underwent TME + LPND were retrospectively analysed and divided into the LPNM group (n = 29) and the non-LPNM group (n = 112). The LPNM group was further subdivided into a high-risk LPNM group (n = 14) and a low-risk LPNM group (n = 15). Propensity score matching (PSM) was performed to minimize selection bias. The primary outcomes of this study were 3-year overall survival (OS) and disease-free survival (DFS).
resultsOf the 141 patients undergoing LPND, the local recurrence rate of patients with LPNM was significantly higher than that of patients without LPNM both before (27.6% vs. 4.5%, P = 0.001) and after (27.6% vs. 3.4%, P = 0.025) PSM. Multivariate analysis revealed that LPNM was an independent risk factor for not only OS (HR: 3.06; 95% CI, 1.15-8.17; P = 0.025) but also DFS (HR: 2.39; 95% CI, 1.18-4.87; P = 0.016) in patients with LPNM after TME + LPND. When the LPNM group was further subdivided, multivariate logistic regression analysis showed that OS and DFS were significantly better in the low-risk group (obturator/internal iliac artery region and < 2 positive LPNs).
conclusionEven after LPND, LPNM patients have a poor prognosis. Moreover, LPNM is an independent poor prognostic factor affecting OS and DFS after TME + LPND. However, LPND appears to confer survival benefits to specific patients with single LPN involvement in the obturator region or internal iliac vessel region. Furthermore, LPND may have no indication in stage IV patients and should be selected carefully.
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