| Effect on the Local Recurrence and the Survival of Total Mesorectal Excision and Lateral Pelvic Lymph Node Dissection in Rectal Cancer. |
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Choi, Byung Gwan , Kim, Hyung Soo , Seo, Kyeong Won , Ju, Jae Kyoon , Ryu, Seong Yeob , Park, Young Kyu , Kim, Hyeong Rok , Kim, Dong Yi , Kim, Young Jin |
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Division of Gastrointestinal Surgery, Department of Surgery, Chonnam National University Medical School, Gwangju, Korea. pping77@naver.com |
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| Abstract |
PURPOSE
One of the most common sites of recurrence after a curative resection of rectal cancer is the pelvis, and local control is a major goal of surgical treatment. The advantages of lateral pelvic lymph node dissection are regarded as questionable because lateral pelvic lymph node metastasis does not occur so frequently and because a lateral lymphadenectomy has a negative influence on the postoperative quality of life. The aim of this study was to clarify if lateral pelvic lymph node dissection (LPLD) conferred any benefit.
METHODS
A total of 769 patients who underwent curative surgery for rectal cancer between 1981 and 2005 at the Department of Surgery, OOO Hospital, were reviewed retrospectively. One hundred ninety-three of these patients underwent a lateral pelvic lymph node dissection, and 576 patients had a total mesorectal excision with high ligation of the IMA.
RESULTS
There was no difference in pathological characteristics between the two groups. Patients who underwent a lateral pelvic lymph node dissection had no statistically significant difference in terms of the 5-year survival rate at stage II and III (64% vs 65% at stage II, P=0.391; 49% vs 47% at stage III, P=0.815).
CONCLUSIONS
A lateral pelvic lymph node dissection has no advantage as part of a standard operation for rectal cancer.
A total mesorectal excision alone has good local control and survival compared with a lateral pelvic lymph node dissection. |
| Key Words:
Rectal cancer; Total mesorectal excision; Lateral pelvic lymph node dissection; Recurrence |
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