Prognostic Significance of Lateral Lymph Node Metastasis Compared to Other Types of Metastasis in Rectal Cancer Patients

摘要

Two pathways are involved in lymphatic drainage of the middle and lower rectum: superior lymphatic drainage along the inferior mesenteric artery and lateral lymphatic drainage along the internal iliac artery (1), Lateral pelvic lymphadenectomy remains a controversial issue in rectal cancer surgery. The clinical importance of the lateral spread of lower rectal cancer was first demonstrated in the 19.50s[2]. Since then, lateral pelvic lymph node dissection (LPLD) has been performed for middle or lower rectal cancer in Japan, and has been shown to have a lower local recurrence rate than that achieved with conventional surgery[3,4]. Lateral lymph node metastases occur in some patients with low rectal cancer and may cause local recurrence after total mesorectal excision. The incidence of lateral pelvic lymph node metastases is variable and regarded as systemic spread, and not as regional disease.