Symposium 11(JSGS・JSGE・JGES)
Sat. November 4th   9:30 - 12:00   Room 5: Portopia Hotel South Wing Ohwada A
Salvage Surgery for Isolated Lateral Lymph Node Recurrence in Rectal Cancer: Experienced from Japanese Tertiary Cancer Center
Tanyawan Heingraj1,2, Akira Ouchi2, Koji Komori2
1Chulalongkorn University, 2Department of Gastroenterological Surgery, Aichi Cancer Center Hospital
Introduction: Salvage surgical treatment for isolated lateral lymph node recurrence (LLNR) of rectal cancer remains a topic of debate. This study aimed to evaluate the clinical outcomes of salvage surgery after rectal cancer surgery without preoperative chemoradiotherapy in Japan.
Methods: Twenty patients with isolated LLNR who underwent salvage surgery at a single Japanese cancer center between 2013 and 2022 were included and analyzed.
Results: Twenty patients with a median follow-up time of 55.6 months included 6 (30%) with lateral lymph node dissection at primary surgery. The location of recurrent lymph nodes was internal iliac in 15 (75%), obturator in 7 (35%), and presacral nodes in 3 (15%) patients. Thirteen (65%) patients required multiorgan resection, and 5 (25%) with permanent stoma creation. Seven (35%) patients developed major complications but no perioperative mortality. Thirteen (65%) patients developed any recurrence, including 8 (40%) local recurrences and 6 (30%) distant recurrences. The three-year cumulative risk for local recurrence was 43.8%, disease-free survival after salvage surgery was 29.4%, and overall survival was 87.5%.
Conclusions: Salvage surgery for isolated LLNR is feasible and possibly provided a survival advantage. Meanwhile, the high recurrence rate implies the importance of lateral local control in primary treatment for rectal cancer.
Index Term 1: lateral lymph node recurrence
Index Term 2: rectal cancer
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