Selective Lateral Pelvic Lymph Node Dissection After Preoperative Chemoradiotherapy in Middle/Low Rectal Cancer

Selective lateral pelvic lymph node dissection after preoperative chemoradiotherapy has been found to decrease local recurrence in middle/low rectal cancer, providing survival benefits. The study investigated the safety, indications, and survival benefits of this procedure based on preoperative characteristics. Results showed that surgery times were significantly prolonged by preoperative chemoradiotherapy, and poor/mucinous/signet-ring adenocarcinoma and postchemoradiotherapy lateral pelvic lymph node short-axis diameter ≥7 mm were independent predictive factors for lateral pelvic lymph node metastasis. Additionally, swollen lateral pelvic lymph nodes beyond the obturator or internal iliac region, as well as involvement of multiple lateral pelvic lymph nodes, were identified as adverse prognostic factors.