Lateral pelvic lymph node dissection (LPND), as a potential radical surgery, is still controversial worldwide. LPNM has been reported in approximately 16–23% of patients with middle to low rectal cancer, and it is an important predictive factor for local recurrence and long-term survival. The lateral lymph node metastasis (LPNM) pathway of middle and low rectal cancer was first proposed by Gerota in 1895, and the anatomical theoretical system of lateral pelvic lymphatic drainage of rectal cancer gradually formed in the 1950s. Furthermore, LPND may have no indication in stage IV patients and should be selected carefully. However, LPND appears to confer survival benefits to specific patients with single LPN involvement in the obturator region or internal iliac vessel region. Moreover, LPNM is an independent poor prognostic factor affecting OS and DFS after TME + LPND. ConclusionĮven after LPND, LPNM patients have a poor prognosis. When the LPNM group was further subdivided, multivariate logistic regression analysis showed that OS and DFS were significantly better in the low-risk group (obturator/internal iliac artery region and < 2 positive LPNs). Multivariate analysis revealed that LPNM was an independent risk factor for not only OS (HR: 3.06 95% CI, 1.15–8.17 P = 0.025) but also DFS (HR: 2.39 95% CI, 1.18–4.87 P = 0.016) in patients with LPNM after TME + LPND. Of the 141 patients undergoing LPND, the local recurrence rate of patients with LPNM was significantly higher than that of patients without LPNM both before (27.6% vs. The primary outcomes of this study were 3-year overall survival (OS) and disease-free survival (DFS). Propensity score matching (PSM) was performed to minimize selection bias. The LPNM group was further subdivided into a high-risk LPNM group ( n = 14) and a low-risk LPNM group ( n = 15). Methodsįrom January 2015 to January 2021, a total of 141 rectal cancer patients with clinical evidence of LPNM who underwent TME + LPND were retrospectively analysed and divided into the LPNM group ( n = 29) and the non-LPNM group (n = 112). The present study aimed to investigate whether the addition of LPND to total mesorectal excision (TME) confers survival benefits in rectal cancer patients with clinical lateral pelvic node metastasis (LPNM). There is still controversy regarding the clinical value and significance of lateral pelvic lymph node (LPN) dissection (LPND).
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