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中低位直肠癌髂内和闭孔淋巴结的处理。

Management of internal iliac and obturator lymph nodes in mid-low rectal cancer.

机构信息

Department of Colorectal Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100021, China.

Fred & Pamela Buffett Cancer Center, University of Nebraska Medical Center, 68198, Omaha, Nebraska, USA.

出版信息

World J Surg Oncol. 2024 Jun 12;22(1):153. doi: 10.1186/s12957-024-03427-0.

DOI:10.1186/s12957-024-03427-0
PMID:38863003
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11167753/
Abstract

In rectal cancer treatment, the diagnosis and management of lateral pelvic lymph nodes (LLN) are critical for preventing local recurrence. Over time, scholars have reached a consensus: when imaging suggests LLN metastasis, combining neoadjuvant chemoradiotherapy (nCRT) with selective LLN dissection (LLND) can mitigate the risk of recurrence. Selective LLND typically encompasses lymph nodes in the internal iliac and obturator regions. Recent studies emphasize distinctions between internal iliac and obturator lymph nodes regarding prognosis and treatment outcomes, prompting the need for differentiated diagnostic and treatment approaches.

摘要

在直肠癌治疗中，侧方骨盆淋巴结（LLN）的诊断和管理对于预防局部复发至关重要。随着时间的推移，学者们已经达成共识：当影像学提示 LLN 转移时，将新辅助放化疗（nCRT）与选择性 LLN 解剖（LLND）相结合可以降低复发风险。选择性 LLND 通常包括髂内和闭孔区域的淋巴结。最近的研究强调了髂内和闭孔淋巴结在预后和治疗结果方面的区别，这促使我们需要采用差异化的诊断和治疗方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e0c4/11167753/77716a053487/12957_2024_3427_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e0c4/11167753/77716a053487/12957_2024_3427_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e0c4/11167753/77716a053487/12957_2024_3427_Fig1_HTML.jpg

相似文献

[1]
Management of internal iliac and obturator lymph nodes in mid-low rectal cancer.

World J Surg Oncol. 2024-6-12

[2]
Selective lateral lymph node dissection after neoadjuvant chemoradiotherapy in rectal cancer.

World J Gastroenterol. 2020-6-7

[3]
The influence of neoadjuvant chemoradiotherapy combined with lateral lymph nodes dissection or not on the local recurrence of low to intermediate-stage II/III rectal cancer.

J Surg Oncol. 2024-2

[4]
Lateral pelvic lymph node dissection after neoadjuvant chemo-radiation for preoperative enlarged lateral nodes in advanced low rectal cancer: study protocol for a randomized controlled trial.

Trials. 2016-11-25

[5]
Local recurrences in western low rectal cancer patients treated with or without lateral lymph node dissection after neoadjuvant (chemo)radiotherapy: An international multi-centre comparative study.

Eur J Surg Oncol. 2021-9

[6]
Prognostic impact of residual lateral lymph node metastasis after neoadjuvant (chemo)radiotherapy in patients with advanced low rectal cancer.

BJS Open. 2019-7-25

[7]
Lateral Nodal Features on Restaging Magnetic Resonance Imaging Associated With Lateral Local Recurrence in Low Rectal Cancer After Neoadjuvant Chemoradiotherapy or Radiotherapy.

JAMA Surg. 2019-9-18

[8]
Rectal cancer lateral lymph nodes: multicentre study of the impact of obturator and internal iliac nodes on oncological outcomes.

Br J Surg. 2021-3-12

[9]
Positive lateral pelvic lymph nodes in low rectal cancer: should we change our practice now?

ANZ J Surg. 2021-5

[10]
Preoperative lateral lymph node features and impact on local recurrence after neoadjuvant chemoradiotherapy and total mesorectal excision for locally advanced rectal cancer: results from a multicentre international cohort study.

Colorectal Dis. 2024-3

引用本文的文献

[1]
KLF12 as a potential biomarker for lateral pelvic lymph node metastases in advanced rectal cancer.

Cancer Immunol Immunother. 2025-5-13

本文引用的文献

[1]
Value of Size and Malignant Features of Lateral Lymph Nodes in Risk Stratification at Lateral Local Recurrence of Rectal Cancer: A National Cohort Study.

J Natl Compr Canc Netw. 2024-2

[2]
[Chinese expert consensus on the diagnosis and treatment for lateral lymph node metastasis of rectal cancer (2024 edition)].

Zhonghua Wei Chang Wai Ke Za Zhi. 2024-1-25

[3]
Invited Commentary. Selective lateral pelvic lymph node dissection in low rectal cancer-Planning for future directions.

Surgery. 2024-2

[4]
Nodal staging with MRI after neoadjuvant chemo-radiotherapy for locally advanced rectal cancer: a fast and reliable method.

Eur Radiol. 2024-5

[5]
MRI-based Radiomics Model for Preoperative Prediction of Lateral Pelvic Lymph Node Metastasis in Locally Advanced Rectal Cancer.

Acad Radiol. 2024-7

[6]
Fascia- vessel-oriented lateral lymph node dissection for rectal cancer: Short-term outcomes and prognosis in a single-center experience.

World J Gastrointest Surg. 2023-6-27

[7]
Prognostic Implications of Lateral Lymph Nodes in Rectal Cancer: A Population-Based Cross-sectional Study With Standardized Radiological Evaluation After Dedicated Training.

Dis Colon Rectum. 2024-1-1

[8]
Management of lateral pelvic lymph nodes in rectal cancer.

J Surg Oncol. 2023-6

[9]
Coverage of Lateral Lymph Nodes in Rectal Cancer Patients with Routine Radiation Therapy Practice and Associated Locoregional Recurrence Rates.

Int J Radiat Oncol Biol Phys. 2023-10-1

[10]
Two-team lateral lymph node dissection assisted by the transanal approach for locally advanced lower rectal cancer: comparison with the conventional transabdominal approach.

Surg Endosc. 2023-7

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