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Is the Lateral Lymph Node Compartment Relevant?

  • Conference paper
Rectal Cancer Treatment

Part of the book series: Recent Results in Cancer Research ((RECENTCANCER,volume 165))

Abstract

Lateral pelvic lymphadenectomy is routinely performed in advanced lower rectal cancers by Japanese surgeons, whereas in the western world it has not progressed to a frequently performed technique. Claimed benefit for this extensive surgery is an improved locoregional control; on the other hand, low positive lateral lymph node yields, questionable prognostic significance, and high morbidity (urinary and sexual dysfunction) are main reasons against this procedure. Clinical results published on lateral lymphadenectomy in the literature are conflicting. Due to major improvements in local control and survival of rectal cancer patients mainly based on preoperative radiotherapy and total mesorectal excision (TME), only a few patients may profit from lateral lymph node dissection. This article gives an overview of the current status and the clinical relevance of the lateral lymph node compartment in rectal cancer surgery.

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References

  1. DiSaia PJ, Creasman WT (1999) Clinical gynecologic oncology. Chicago: Mosby-Year Book

    Google Scholar 

  2. Heidenreich A, Varga Z, von Knobloch R (2002) Extended pelvic lymphadenectomy in patients undergoing radical prostatectomy: high incidence of lymph node metastasis. J Urol 167:1681–1686

    Article  PubMed  Google Scholar 

  3. Takahashi T, Ueno M, Azekura K, Ohta H(2000) Lateral node dissection and total mesorectal excision for rectal cancer. Dis Colon Rectum 43(Suppl):S59–S68

    PubMed  Google Scholar 

  4. Morikawa E, Yasutomi M, Shindou K, Matsuda T, Mori N, Hida J, et al (1994) Distribution of metastatic lymph nodes in colorectal cancer by the modified clearing method. Dis Colon Rectum 37:219–223

    Article  PubMed  Google Scholar 

  5. Ueno H, Yamauchi, Hase K, Ichikura T, Mochizuki H (1999) Clinicopathological study of intrapelvic cancer spread to the iliac area in lower rectal adenocarcinoma by serial sectioning. Br J Surg 86:1532–1537

    Article  PubMed  Google Scholar 

  6. Canessa CE, Miegge LM, Bado J, Silveri C, Labandera D(2004) Anatomic study of lateral pelvic lymph nodes: implications in the treatment of rectal cancer. Dis Colon Rectum 47:297–303

    Article  PubMed  Google Scholar 

  7. Morita T, Murata A, Koyama M, Totsuka E, Sasaki M(2003)Current status of autonomic nervepreserving surgery for mid and lower rectal cancers. Dis Colon Rectum 46(Suppl):S78–S88

    PubMed  Google Scholar 

  8. Mori T, Takahashi K, Yasuno M (1998) Radical resection with autonomic nerve presentation and lymph node dissection techniques in lower rectal cancer surgery and its results: the impact of lateral lymph node dissection. Langenbeck's Arch Surg 383:409–415

    Article  Google Scholar 

  9. Dong XS, Xu HT, Yu ZW, Liu M, Cui BB, Zhao P, et al (2003) Effect of extended radical resection for rectal cancer. World J Gastroenterol 9:970–973

    PubMed  Google Scholar 

  10. Hida J, Yasutomi M, Tokoro T, Kubo R (1999) Examination of nodal metastases by a clearing method supports pelvic plexus preservation in rectal cancer surgery. Dis Colon Rectum 42:510–514

    PubMed  Google Scholar 

  11. Fujita S, Yamamoto S, Akasu T, Moriya Y (2003) Lateral pelvic lymph node dissection for advanced lower rectal cancer. Br J Surg 90:1580–1585

    Article  PubMed  Google Scholar 

  12. Ueno H, Mochizuki H, Hashiguchi Y, Hase K (2001) Prognostic determinants of patients with lateral nodal involvement by rectal cancer. Ann Surg 234:190–197

    Article  PubMed  Google Scholar 

  13. Moriya Y, Sugihara K, Akasu T, Fujita S (1997) Importance of extended lymphadenectomy with lateral node dissection for advanced lower rectal cancer. World J Surg 21:728–732

    Article  PubMed  Google Scholar 

  14. Hojo K, Sawada T, Moriya Y (1989) An analysis of survival and voiding, sexual function after wide iliopelvic lymphadenectomy in patients with carcinoma of the rectum, compared with conventional lymphadenectomy. Dis Colon Rectum 32:128–133

    PubMed  Google Scholar 

  15. Shimoyama M, Yamazaki T, Suda T, Hatakeyama K (2003) Prognostic significance of lateral lymph node micrometastases in lower rectal cancer. Dis Colon Rectum 46:333–339

    Article  PubMed  Google Scholar 

  16. Saito N, Koda K, Takiguchi N, Oda K, Soda H, Nunomura M et al (1999) Nerve-sparing surgery for advanced rectal cancer patients: special reference to Dukes C patients. World J Surg 23:1062–1068.

    Article  PubMed  Google Scholar 

  17. Uyama I, Sugioka A, Matsui H, Fujita J, Komori Y, Hanai T et al (2001) Laparoscopic lateral node dissection with autonomic nerve preservation for advanced lower rectal cancer. J Am Coll Surg 193:579–584

    Article  PubMed  Google Scholar 

  18. Heald RJ, Husband EM, Ryall RD (1982) The mesorectum in rectal cancer surgery: the clue to pelvic recurrence? Br J Surg 69:613–616

    PubMed  Google Scholar 

  19. Heald RJ, Ryall RD (1986) Recurrence and survival after total mesorectal excision for rectal cancer. Lancet 28:1479–1482

    Article  Google Scholar 

  20. Enker WE, Thaler HT, Cranor ML, Polyak T (1995) Total mesorectal excision in the operative treatment of carcinoma of the rectum. J Am Coll Surg 181:335–346

    PubMed  Google Scholar 

  21. Swedish Rectal Cancer Trial (1997) Improved survival with preoperative radiotherapy in resectable rectal cancer. N Engl J Med 336:980–987

    Google Scholar 

  22. Kapiteijn E, Marijnen CA, Nagtegaal ID, Putter H, Steup WH, Wiggers T, et al (2001) Preoperative radiotherapy combined with total mesorectal excision for resectable rectal cancer. N Engl J Med 345:638–646

    PubMed  Google Scholar 

  23. Watanabe T, Tsurita G, Muto T, Sawada T, Sunouchi K, Higuchi Y, et al (2002) Extended lymphadenectomy and preoperative radiotherapy for lower rectal cancers. Surgery 132:27–33

    Article  PubMed  Google Scholar 

  24. Koda K, Saito N, Oda K, Takiguchi N, Sarashina H, Miyazaki M (2004) Evaluation of lateral lymph node dissection with preoperative chemo-radiotherapy for the treatment of advanced middle to lower rectal cancers. Int J Colorectal Dis 19:188–94

    Article  PubMed  Google Scholar 

  25. Nagawa H, Muto T, Sunouchi K, Higuchi Y, Tsurita G, Watanabe T, et al (2001) Randomized, controlled trial of lateral node dissection vs. nerve-preserving resection in patients with rectal cancer after preoperative radiotherapy. Dis Colon Rectum 44:1274–1280

    PubMed  Google Scholar 

  26. Havenga K, Enker WE, Norstein J, Moriya Y, Heald RJ, van Houwelingen HC, et al (1999) Improved survival and local control after total mesorectal excision or D3 lymphadenectomy in the treatment of primary rectal cancer: an international analysis of 1411 patients. Eur J Surg Oncol 25:368–374

    Article  PubMed  Google Scholar 

  27. Mulsow J, Winter DC, O'Keane JC, O'Connell PR (2003) Sentinel lymph node mapping in colorectal cancer. Br J Surg 2003;90:659–667

    Article  PubMed  Google Scholar 

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Author information

Authors and Affiliations

  1. Department of Surgery, University of Heidelberg, 69120, Heidelberg, Germany

    Moritz Koch

Authors
  1. Moritz Koch
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  2. Peter Kienle
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  3. Dalibor Antolovic
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  4. Markus W. Büchler
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  5. Jürgen Weitz
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Editor information

Editors and Affiliations

  1. Abteilung für Allgemeine, Viszerale, Unfallchirurgie und Poliklinik, Chirurgische Universitätsklinik Heidelberg, Im Neuenheimer Feld 110, 69120, Heidelberg, Germany

    Markus W. Büchler  & Jürgen Weitz  & 

  2. Chirurgie, Krankenhaus Gerresheim, Kliniken der Landeshauptstadt, Gräulinger Straße 120, 40625, Düsseldorf, Germany

    Bernward Ulrich

  3. The Pelican Cancer Foundation, North Hampshire Hospital, Basingstoke, Hampshire, RG24 9NA, UK

    Richard John Heald (OBE, Surgical Director) (OBE, Surgical Director)

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© 2005 Springer-Verlag Berlin Heidelber

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Koch, M., Kienle, P., Antolovic, D., Büchler, M.W., Weitz, J. (2005). Is the Lateral Lymph Node Compartment Relevant?. In: Büchler, M.W., Weitz, J., Ulrich, B., Heald, R.J. (eds) Rectal Cancer Treatment. Recent Results in Cancer Research, vol 165. Springer, Berlin, Heidelberg. https://doi.org/10.1007/3-540-27449-9_6

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  • DOI: https://doi.org/10.1007/3-540-27449-9_6

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-540-23341-1

  • Online ISBN: 978-3-540-27449-0

  • eBook Packages: MedicineMedicine (R0)

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