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Journal of Cancer Research and Clinical Oncology

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15.03.2018 | Original Article – Clinical Oncology

Mapping of lateral pelvic lymph node recurrences in rectal cancer: a radiation oncologist’s perspective

verfasst von: Seo Hee Choi, Jee Suk Chang, Hong In Yoon, Dong-Su Jang, Nam Kyu Kim, Joon Seok Lim, Byung So Min, Hyuk Huh, Sang Joon Shin, Joong Bae Ahn, Woong Sub Koom

Erschienen in: Journal of Cancer Research and Clinical Oncology | Ausgabe 6/2018

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Abstract

Purpose

Patterns of locoregional rectal cancer recurrences following total mesorectal excision (TME) were analyzed to define the irradiation volume, especially the lateral pelvic lymph node (LPLN).

Materials and methods

Of 1243 patients who underwent TME without pelvic radiotherapy between 2005 and 2012, the data of 826 patients with rectal adenocarcinoma without distant metastases were analyzed for relapse patterns, categorized as distant and locoregional (anastomosis, mesorectum, presacral area, and LPLNs) failure.

Results

The median follow-up was 61.8 months. The 5-year local recurrence-free, distant metastasis-free, overall survival rates were 88, 82, and 89%, respectively. Relapse occurred in 108 (13%) patients: 90 (11%) had distant and 28 (3%) had locoregional failure. Eight patients had LPLN recurrence: the 2 recurrences from upper rectal cancers occurred near the bifurcation of the common iliac artery into the external and internal iliac vessels; the 6 mid-lower rectal cancers had 16 recurrences near the internal iliac and obturator arteries—five occurred anterior to the obturator artery and posterior to the external iliac artery, superior to the femoral head. LPLN recurrence was associated with pN2 stage, perinodal extension, and lymphovascular invasion.

Conclusion

The LPLN component of pre- or postoperative irradiation volumes could potentially be optimized based on our mapping data. However, since patients in our institution at high risk for relapse received either preoperative or postoperative chemoradiation, further analyses are needed to confirm our findings.

Nur mit Berechtigung zugänglich

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Titel: Mapping of lateral pelvic lymph node recurrences in rectal cancer: a radiation oncologist’s perspective
verfasst von: Seo Hee Choi
Jee Suk Chang
Hong In Yoon
Dong-Su Jang
Nam Kyu Kim
Joon Seok Lim
Byung So Min
Hyuk Huh
Sang Joon Shin
Joong Bae Ahn
Woong Sub Koom
Publikationsdatum: 15.03.2018
Verlag: Springer Berlin Heidelberg
Erschienen in: Journal of Cancer Research and Clinical Oncology / Ausgabe 6/2018
Print ISSN: 0171-5216
Elektronische ISSN: 1432-1335
DOI: https://doi.org/10.1007/s00432-018-2624-6

Springer Medizin

Mapping of lateral pelvic lymph node recurrences in rectal cancer: a radiation oncologist’s perspective