The regional lymphatic areas of lower rectum are classified among four areas, i.e., mesorectal area, superior rectal artery (SRA) area, inferior mesenteric artery (IMA) area, and lateral area. Anatomy of lymphatic drainage in rectal cancer
#Pelvic lymph nodes trial#
The conclusions of a four-arm trial (INT-0089) has indicated that the overall survival and cancer specific survival is significantly high as the number of reported lymph nodes increases even with negative nodes. The minimum of 12 lymph nodes should be examined in order to confirm the node negativity in rectal cancer. Lateral pelvic lymph node (LPLN) metastasis in rectal cancer is considered as systemic disease. The prognostic importance of lymph node metastasis in rectal cancer has been proven with multiple trials and is broadly applied in the patient management. Rectal cancer Lateral pelvic lymph node Metastasis Regional recurrence Background Hence, the risk factors for lateral pelvic lymph node metastasis in patients with rectal cancer can be effectively studied in a broad set up because it may be a poor prognostic factor and the extended lymph node dissection might have a therapeutic role.
The importance of lymphadenectomy respective to these lateral pelvic areas is of prognostic benefit both in survival as well as local control of the disease and also it determines the optimal extent of lymphadenectomy.
#Pelvic lymph nodes free#
The extent of lymphatic spread in rectal cancer can be divided into mesorectal and extra-mesorectal lateral pelvic lymph node metastasis and it is the most important parameter regarding post-operative recurrence free as well as overall survival. The overall recurrence rate after curative resection in rectal cancer is more than 20% reported in various studies and the LPLNs metastasis is an independent risk factor for local recurrence. The incidence of lateral lymph node involvement has been reported as 10 to 25% of all rectal cancers.
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