Department of Surgical Oncology, Val d'Aurelle Anticancer Centre, 34298 Montpellier Cedex 5, France.
Surg Oncol. 2011 Dec;20(4):e227-33. doi: 10.1016/j.suronc.2011.08.004. Epub 2011 Sep 10.
Lymph node status at the time of diagnosis remains one of the principal indicators of prognosis in patients with rectal cancer. Involvement of loco-regional lymph nodes is relevant to surgical and clinical oncologists and continues to impact significantly upon local and systemic management strategies, in both neo-adjuvant and adjuvant settings. In this review, the clinical impact of lymph node status in the surgical management of rectal cancer is considered, with particular reference to the significance of lymphadenectomy and the potential implications for rectal tumours amenable to trans-anal excision. Current standards of care are reviewed and the extent to which the determination of lymph node status influences oncological decisions regarding neo-adjuvant and adjuvant therapies are discussed with areas of controversy highlighted.
在诊断时的淋巴结状态仍然是直肠癌患者预后的主要指标之一。局部淋巴结受累与外科肿瘤学家和临床肿瘤学家都相关，并继续对新辅助和辅助治疗策略产生重大影响，无论是局部还是全身管理策略。在这篇综述中，考虑了淋巴结状态在直肠癌外科治疗中的临床影响，特别提到了淋巴结切除术的意义，以及对可经肛门切除的直肠肿瘤的潜在影响。回顾了当前的治疗标准，并讨论了淋巴结状态的确定在多大程度上影响了新辅助和辅助治疗的肿瘤学决策，强调了有争议的领域。
