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Treatment results of the patients with locally advanced lower rectal cancer who received neoadjuvant chemotherapy followed by lateral lymph nodes dissection
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K. Uehara1,
T. Aiba1,
M. Nagino1 |
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1Department of Surgery, Division of Surgical Oncology, Nagoya University Graduate School of Medicine |
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| Background: Since 2009, we indicated the neoadjuvant oxaliplatin-based chemotherapy (NAC) for locally advanced lower rectal cancer (LARC). Our indication of lateral pelvic lymph node dissection (LPLD) is based on the Japanese guidelines of colorectal cancer. That is, stage II/III lower rectal cancer is indicated to the additional LPLD. Method: Between 2009 and 2015, 62 patients with lower LARC received NAC followed by curative resection. Of these, 51 patients excluding 11 patients who underwent pelvic exenteration were retrospectively analyzed. LNs whose short axis was 5mm or longer were judged as positive in CT. Results: LPLD was performed by open (n=19), laparoscopic (n=24), or robotic (n=8) approach. 25 patients underwent unilateral LPLD and 17 patients were required combined resection of the partial nerve. The incidence of the postoperative urinary dysfunction was 5.9%. Among the 21 patients who had positive lateral LNs (LLNs) preoperatively, 9 (43%) were judged as having pathological positive LLNs. Recurrence occurred in 13 patients including local relapse (n=2) and opposite-sided LLNs (n=2). As a result, the local recurrence rate was 7.8%. Conclusion: We show our treatment results of patients with lower LARC who received NAC followed by LPLD. |
Index Term 1: lower rectal cancer
Index Term 2: lateral lymph node |
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