| International Session（Symposium）6(JSGS・JSGE・JGES) |
| Fri. November 22nd 9:30 - 12:00 Room 12: Kobe International Conference Center Main Hall |
| Multidisciplinary Approach to Locally Advanced Rectal Cancer with Lateral Pelvic Lymph Node Metastases | |||
| George J. Chang | |||
| The University of Texas M.D. Anderson Cancer Center | |||
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| The optimal management of rectal cancer with clinical evidence of lateral pelvic lymph node metastasis remains an important treatment concern. Despite the use of neoadjuvant chemoradiation therapy and total mesorectal excision, lateral compartment recurrence is an important clinical concern. Conversely, despite the incorporation of lateral pelvic lymph node dissection, pelvic recurrence is still and important problem for patients confirmed to have lateral pelvic lymph node metastases. For patients with clinical evidence for lateral pelvic lymph node metastasis, optimal treatment should include both multimodality chemoradiation therapy and selective lateral pelvic lymph node dissection. However, the criteria for dissection is still unknown. We performed a retrospective analysis of patients who underwent LPLND following neoadjuvant chemoradiation therapy at the University of Texas, MD Anderson Cancer Center between 2006 and 2013 and examined the association between post-treatment size and pathologic lymph node positivity and recurrence outcomes. 51 patients had post-treatment lymph node size ≥5 mm, and among those 33 (64.7%) patients had pathologically positive lateral nodes. No patients with post-treatment lymph node <5 mm had pathologically positive lymph nodes following dissection. There were no lateral compartment recurrences in the entire cohort. The overall treatment strategy for patients with clinical evidence for lateral pelvic lymph node metastasis should include the combination of chemoradiation therapy and lateral pelvic lymph node dissection. This approach may be applied in both Western and Eastern patients. |
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Index Term 1: Lateral Pelvic Lymph Node Dissection Index Term 2: Multidisciplinary Treatment |
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