Management of lateral pelvic lymph nodes in rectal cancer:Is it time to reach an Agreement?  

作　　者：Sigfredo E Romero-Zoghbi Fernando López-Campos Felipe Couñago 

机构地区：[1]Department of Radiation Oncology,GenesisCare,Talavera de la Reina 45600,Toledo,Spain [2]Department of Radiation Oncology,Hospital Universitario Ramón Y Cajal,Madrid 28034,Spain [3]Department of Radiation Oncology,GenesisCare-Hospital Universitario Vithas Madrid La Milagrosa,Madrid 28010,Spain

出　　处：《World Journal of Clinical Oncology》2024年第4期472-477,共6页世界临床肿瘤学杂志（英文版）

摘　　要：In this editorial,we proceed to comment on the article by Chua et al,addressing the management of metastatic lateral pelvic lymph nodes(mLLN)in stage II/III rectal cancer patients below the peritoneal reflection.The treatment of this nodal area sparks significant controversy due to the strategic differences followed by Eastern and Western physicians,albeit with a higher degree of convergence in recent years.The dissection of lateral pelvic lymph nodes without neoadjuvant therapy is a standard practice in Eastern countries.In contrast,in the West,preference leans towards opting for neoadjuvant therapy with chemoradiotherapy or radiotherapy,that would cover the treatment of this area without the need to add the dissection of these nodes to the total mesorectal excision.In the presence of high-risk nodal characteristics for mLLN related to radiological imaging and lack of response to neoadjuvant therapy,the risk of lateral local recurrence increases,suggesting the appropriate selection of strategies to reduce the risk of recurrence in each patient profile.Despite the heterogeneous and retrospective nature of studies addressing this area,an international consensus is necessary to approach this clinical scenario uniformly.

关 键 词：Rectal cancer Lateral pelvic lymph node metastases Pelvic lymph node dissection Total neoadjuvant therapy Selective management of the lateral pelvic nodes Prophylactic management of the lateral pelvic nodes CHEMORADIOTHERAPY Total mesorectal excision 

分 类 号：R739.8[医药卫生—肿瘤]