Trial reportAnnals of surgery2025
Association of Lateral Pelvic Lymph Nodes with Disease Recurrence and Organ Preservation in Patients with Distal Rectal Adenocarcinoma Treated with Total Neoadjuvant Therapy.
Trial report in Annals of surgery, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers, 1 of them a synthesis that pooled it.
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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.
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Who cites it
12 citing papers in PubMed, 1 synthesis or guideline pooled it, 17 citations in OpenAlex.
- Watch-and-Wait strategy for locally advanced rectal cancer after neoadjuvant chemoradiotherapy: a comprehensive review.Frontiers in oncology · 2026Pooled it
- Lateral pelvic lymph nodes in rectal cancer: a narrative review.Abdominal radiology (New York) · 2026Review
- Is Total Neoadjuvant Therapy the Solution to the Lateral Pelvic Lymph Nodes in Rectal Cancer? Retrospective Analysis From a High-Volume Tertiary Care Center.Annals of surgical oncology · 2026Article
- Nomogram for predicting lymph node metastasis in ypT0-2 rectal cancer after neoadjuvant chemoradiotherapy.International journal of colorectal disease · 2026Article
- Locally Recurrent Rectal Cancer in the Lateral Compartment: Imaging Features and Association with Primary Tumour Characteristics.Annals of surgical oncology · 2026Article
- "Discrepancies in the Reactivity of Mesorectal Versus Lateral Lymph Nodes Post-Neoadjuvant Chemoradiotherapy for Rectal Cancer: Insights from Radiological and Pathological Perspectives," by Zhuang et al.Annals of surgical oncology · 2025Article
- Evaluation of Short-Term Postoperative Outcomes of Lateral Lymph Node Dissection After Neoadjuvant Radiotherapy for Rectal Cancer Patients: The Early Learning Phase After Surgical Training in the Netherlands.Annals of surgical oncology · 2025Article
- A Review on the Evolving Role of Radiation Therapy in the Treatment of Locally Advanced Rectal Cancer.Current oncology (Toronto, Ont.) · 2025Review
- A comparison of the diagnostic ability of 1-mm computed tomography and 3-mm magnetic resonance imaging for detecting lateral pelvic lymph node metastases from rectal cancer.Surgery today · 2025Observational
- Neoadjuvant therapy for lateral pelvic lymph nodes: choosing between long course chemoradiation or short course radiotherapy with consolidation chemotherapy.Techniques in coloproctology · 2025Article
- Positive lateral lymph node turned negative after neoadjuvant therapy-surgery or observation?Techniques in coloproctology · 2025Review
- ASO Perspective Regarding Issues by the Phase II OPRA Trial and Rectal Adenocarcinoma Treated with Total Neoadjuvant Therapy.Annals of surgical oncology · 2024Article
Corrections and comments
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Authors and funding
19 authors at 2 institutions in 2 countries.
Funding
Abstract
objectiveTo assess the significance of enlarged lateral lymph nodes (LLN) for disease recurrence, metastasis, and organ preservation in patients with rectal cancer.
backgroundOptimal treatment of rectal adenocarcinoma involving LLN is subject to debate.
methodsA post hoc analysis of the Organ Preservation in Rectal Adenocarcinoma trial, a multicenter study of patients with rectal cancer treated with total neoadjuvant therapy (TNT) followed by total mesorectal excision or watch-and-wait management. We analyzed the association of visible LLN (LLN+), LLN ≥7 mm (short axis) on baseline magnetic resonance imaging (MRI), and LLN ≥4 mm on restaging MRI with recurrence, metastasis, and rectum preservation.
resultsAt baseline, 57 out of 324 (18%) patients had LLN+. In 30 (53%) of 57 patients with LLN+ on baseline MRI, the LLN disappeared after TNT. Disease recurrence in LLN was rare (3.5% of patients with LLN+ and 0.4% of patients with LLN-). All patients with recurrence in LLN also had distant metastasis. The rate of organ preservation was significantly lower in patients with LLN ≥4 mm on restaging MRI ( P = 0.013). We found no significant differences in rates of local recurrence or metastasis between patients with LLN+ versus LLN- and in patients with LLN ≥7 versus <7 mm on baseline MRI. LLN dissection was performed in 3 patients; 2 of them died of distant metastasis.
conclusionsLLN involvement is not associated with disease recurrence or metastasis, but persistence of LLN ≥4 mm after TNT is negatively associated with rectum preservation in patients with locally advanced rectal cancer treated with TNT. Dissection of lateral nodes likely benefits few patients.
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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.