| International Session（Symposium）6(JSGS・JSGE・JGES) |
| Fri. November 22nd 9:30 - 12:00 Room 12: Kobe International Conference Center Main Hall |
| Lateral nodal disease: what does it mean to us in Japan in the era of multidisciplinary treatment? | |||
| Tsuyoshi Konishi1, Kensei Yamaguchi1, Yosuke Fukunaga1 | |||
| 1Cancer Institute Hospital of the Japanese Foundation for Cancer Research | |||
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| In Japan, it has been treated as regional disease. A recent randomized trial that compared TME alone vs. TME with lateral node dissection for patients with T3-4 low rectal cancer demonstrated decreased local recurrence by adding lateral node dissection. In western countries, lateral nodal disease has been generally considered to be distant metastasis. Further, it has been assumed that lateral local recurrence can be prevented by neoadjuvant chemoradiation. However, studies demonstrated high local recurrences after neoadjuvant chemoradiotherapy plus TME alone if lateral nodes were clinically positive. A recent study from Japan reported excellent oncological outcomes in patients with clinically enlarged lateral nodes by combining neoadjuvant chemoradiotherapy with selective lateral lymph node dissection. A recent large international collaborative study also supported educed local recurrence after chemoradiation by adding lateral node dissection to TME if lateral nodes were enlarged. These data suggest that lateral nodal disease is regional and can be cured by combining chemoradiotherapy plus lateral node dissection. With a recent development of totally neoadjuvant therapy, we need more evidences to identify which patient groups would truly benefit from lateral node dissection in the era of modern neoadjuvant treatment. |
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Index Term 1: Lateral lymph node Index Term 2: neoadjuvant therapy |
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