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©The Author(s) 2020. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Jun 7, 2020; 26(21): 2877-2888
Published online Jun 7, 2020. doi: 10.3748/wjg.v26.i21.2877
Published online Jun 7, 2020. doi: 10.3748/wjg.v26.i21.2877
Selective lateral lymph node dissection after neoadjuvant chemoradiotherapy in rectal cancer
Jia-Nan Chen, Zheng Liu, Zhi-Jie Wang, Shi-Wen Mei, Hai-Yu Shen, Juan Li, Wei Pei, Zheng Wang, Xi-Shan Wang, Qian Liu, Department of Colorectal Surgery, National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union College, Beijing 100021, China
Jun Yu, Departments of Surgery, the Johns Hopkins University School of Medicine, Baltimore, MD 21218, United States
Author contributions: Chen JN and Wang ZJ designed the research; Mei SW, Shen HY, and Li J collected the data; Pei W, Wang Z, and Liu Z analyzed the data; Chen JN drafted the article; Liu Q, Yu J, and Wang XS revised the paper.
Supported by the Medicine and Health Technology Innovation Project of Chinese Academy of Medical Sciences , No. 2017-12M-1-006 ; and China Scholarship Council , No. CSC201906210471 .
Institutional review board statement: The study was reviewed and approved by the Institutional Review Board of the National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College.
Informed consent statement: All patients signed informed consent forms.
Conflict-of-interest statement: The authors declare there is no conflict of interest in regard to this research.
Data sharing statement: No additional data are available.
STROBE statement: The authors have carefully read the STROBE statement checklist of items and prepared the manuscript based on the requirements of the STROBE statement checklist of items.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Qian Liu, MD, Chief Doctor, Professor, Surgeon, Department of Colorectal Surgery, National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No. 17 Panjiayuan Nanli, Chaoyang District, Beijing 100021, China. fcwpumch@163.com
Received: January 7, 2020
Peer-review started: January 7, 2020
First decision: February 19, 2020
Revised: April 17, 2020
Accepted: April 28, 2020
Article in press: April 28, 2020
Published online: June 7, 2020
Peer-review started: January 7, 2020
First decision: February 19, 2020
Revised: April 17, 2020
Accepted: April 28, 2020
Article in press: April 28, 2020
Published online: June 7, 2020
Core Tip
Core tip: Lateral lymph node metastasis is one of the leading causes of local recurrence in patients with advanced mid or low rectal cancer. Lateral local recurrence remains a significant clinical problem associated with severe morbidity and low salvage likelihood. There is an East (mainly Japan)-West divide regarding the management of lateral lymph nodes associated with lower rectal cancer. Preoperative chemoradiotherapy followed by total mesorectal excision is a standard procedure in the west. Our study shows that lateral lymph node metastasis cannot be eradicated by neoadjuvant chemoradiotherapy. Selective total mesorectal excision plus lateral lymph node dissection should be performed in advanced mid or low rectal cancer patients.