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Showing posts from November, 2018

Importance of Lateral Rectal Lymph node in Low Rectal Cancer

1. A case of Lateral Rectal LNs failure, 2. Concept of Lateral Lymph node involvement Reference 1: Key Factor Sammour T, Chang GJ.  Lateral pelvic lymph node dissection and radiation treatment for rectal cancer: Mutually exclusive or mutually beneficial?Ann Gastroenterol Surg. 2018;00:1–3.  https://doi.org/10.1002/ags3.12197  .    LRLN in case of low or mid RC should be considered as a part of regional disease and to be mutually addressed during nCRT & Sx.  Low risk of LPLN disease (cT1/T2/early T3) (and Ra*) with cN0-LPLN on MRI: Treatment by  TME.  Moderate risk of LPLN disease (cT3/4 with cN0-LPLN on MRI <7mm) (or Rb**): treatment by  nCRT + TME +/- LPLND.  High risk of LPLN disease (cN1-LPLN on MRI  >7mm) (Ra or Rb): treatment by  nCRT + TME + LPLND.  * Ra- above peritoneal reflection **Rb-below peritoneal reflection.  Reference 2: Key Factors- Ogura A et al. Neoadjuvant (Chemo)radiotherapy With Total Mesorectal Excision Only Is Not Sufficient t