Authors
Tsarkov P.V., Babajanyan A.R., Tulina I.A., Khusainov A.R., Sidorova L.V., Lukyanov A.M.
University Clinical Hospital №2 I.M. Sechenov First Moscow State Medical University, Moscow
Abstract
At the core of the rectal cancer treatment lie the principles of lymph node metastasis, which occur through ascending, descending and lateral pathways. The lateral lymph node (LLN) metastasis is the most frequent pathway for low and middle rectal cancer. The frequency of lateral pelvic lymph node lesions ranges from 1% to 23%. Nevertheless, it still remains unclear what effects the frequency of lateral lymph node metastasis.
Objective: detecting risk factors of lateral lymph node metastasis in rectal cancer.
Methods: Study of 120 cases of rectal cancer treated with uni- or bilateral pelvic lymph node dissection. There was conducted a databased research of odds ratio and multi-factor analysis. There were detected risk factors that affect frequency of lateral lymph node metastasis.
Results: Lateral lymph node lesions are proven to occur more frequently in cases of positive EMVI; LLN sized equal or bigger than 8mm; mucinous adenocarcinoma and mesorectal lymph node lesions. Lateral pelvic lymph node dissection should be considered in cases of T2 tumor invasion and deeper. Сhemoradiotherapy is insufficient for LLN elimination and does not affect frequency of lateral lymph node lesions.
Keywords: rectal cancer, lateral pelvic lymph node dissection, lateral lymph nodes, risk factors.
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