Is there a Role of Lateral Pelvic Lymph Node Dissection in the Current Era of Neoadjuvant Chemoradiotherapy for Rectal Cancer?
Girish K Kundagulwar, Vishwas D Pai and Avanish P Saklani*
Department of Surgical Oncology, Tata Memorial Centre, Mumbai, Maharashtra, India
- *Corresponding Author:
- Dr. Avanish P Saklani
Colorectal and Robotic Surgery
Department of Surgical Oncology
Tata Memorial Centre, Ernest Borges Road
Mumbai, Maharashtra, India
Email: [email protected]
Received date: September 09, 2016; Accepted date: September 23, 2016; Published date: September 29, 2016
Citation: Kundagulwar GK, Pai VD, Saklani AP (2016) Is there a Role of Lateral Pelvic Lymph Node Dissection in the Current Era of Neoadjuvant Chemoradiotherapy for Rectal Cancer?. J Gastrointest Dig Syst 6:473. doi: 10.4172/2161-069X.1000473
Copyright: © 2016 Kundagulwar GK. This is an open-access article distributed under the terms of the Creative Commons Attribution License; which permits unrestricted use; distribution; and reproduction in any medium; provided the original author and source are credited.
Colorectal cancer is the third most common cancer in men. Total mesorectal excision remains the gold standard treatment for rectal cancer with chemoradiotherapy preceding the surgery in all locally advanced rectal malignancies. Lateral pelvic lymph node dissection (LPLND), although a part of standard surgery for rectal cancers treatment in Japan has not been adopted by surgeons in the rest of the world. There is a long-standing controversy on whether lateral pelvic node metastasis represents localized or metastatic disease. Current standard in Japan is to consider lateral pelvic nodes as regional disease and, hence, perform prophylactic LPLND in low rectal cancers of stage T3 or more or with involved mesorectal nodes. In contrast, standard therapy in west is to consider lateral pelvic nodes as systemic disease and, hence, to either ignore them or treat obvious nodes with chemoradiotherapy. In Japan, neoadjuvant chemoradiotherapy (NACTRT) is less commonly used for locally advanced rectal cancers in contrast to the practice in the west. The role of LPLND in patients receiving NACTRT remains to be established. The aim of this article is to review the evidence for the role of LPLND in the current era of NACTRT.