Lateral pelvic lymph node dissection and radiation treatment for rectal cancer: Mutually exclusive or mutually beneficial?

Lateral pelvic lymph nodes (LPLN) in mid‐/low rectal cancer pose a theoretical and practical challenge for the clinician and the patient, with geographical differences in management based on historical competing priorities. Although there has been a tendency to think of neoadjuvant radiation versus...

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Bibliographic Details
Published in:Annals of gastroenterological surgery 2018-09, Vol.2 (5), p.348-350
Main Authors: Sammour, Tarik, Chang, George J.
Format: Article
Language:English
Subjects:
Biopsy
Cancer surgery
Cancer therapies
chemoradiotherapy for rectal cancer
Chemotherapy
Colorectal cancer
Dissection
lateral pelvic lymph node
lateral pelvic lymph node dissection
Lymphatic system
Medical prognosis
Metastasis
multidisciplinary treatment for rectal cancer
NMR
Nuclear magnetic resonance
Patients
Radiation therapy
rectal cancer
Review
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Summary:Lateral pelvic lymph nodes (LPLN) in mid‐/low rectal cancer pose a theoretical and practical challenge for the clinician and the patient, with geographical differences in management based on historical competing priorities. Although there has been a tendency to think of neoadjuvant radiation versus intraoperative LPLN dissection as a binary choice, they should be more constructively seen as complementary options in the personalized management of patients with rectal cancer. Herein we propose one potential algorithm for using these treatment options in this way based on local preoperative staging and the current evidence available. We also outline future research priorities in this area with the aim of answering several residual questions that remain.
ISSN:2475-0328
2475-0328
DOI:10.1002/ags3.12197