Lateral Lymph Nodes in Rectal Cancer: Do we all Think the Same? A Review of Multidisciplinary Obstacles and Treatment Recommendations

Tania C Sluckin, Alice M Couwenberg, Doenja M J Lambregts, Sanne-Marije J A Hazen, Karin Horsthuis, Philip Meijnen, Regina G H Beets-Tan, Pieter J Tanis, Corrie A M Marijnen, Miranda Kusters*

*Corresponding author for this work

Research output: Contribution to journal(Systematic) Review article peer-review

Abstract

Lateral lymph nodes in low, locally advanced, rectal cancer have proven implications for local recurrence rates, which increase drastically in the presence of persistently enlarged lateral lymph nodes. These clinical implications warrant a thorough understanding of lateral nodal disease with awareness and knowledge from all three specialties involved - radiology, radiation oncology, and surgery - to ensure proper treatment. Relevant literature for each specialty, including all current guidelines and perspectives, were examined. Variations in definitions and treatment paradigms were evaluated. There is still no consensus for the standardized treatment of lateral nodal disease. Each discipline works according to their own available evidence, but relevant data are scarce. Current international guidelines and standard recommendations for the diagnostics and treatment of lateral lymph nodes are lacking. This results in differing perspectives and interpretations between the disciplines which can lead to challenging communication in an area where multidisciplinary collaboration is essential. This review addresses this by presenting the current evidence, perspectives and practices of each specialty and makes suggestions for each phase of the diagnostic and treatment process for patients with lateral nodal disease. By doing this, steps are taken toward achieving international consensus, and multidisciplinary collaboration.

Original languageEnglish
Pages (from-to)80-88
Number of pages9
JournalClinical Colorectal Cancer
Volume21
Issue number2
Early online date19 Feb 2022
DOIs
Publication statusPublished - Jun 2022

Keywords

  • CHEMORADIATION
  • COMPARING MESORECTAL EXCISION
  • DISSECTION
  • LYMPHADENECTOMY
  • METASTASIS
  • Multidisciplinary team
  • NODAL DISEASE
  • PREOPERATIVE CHEMORADIOTHERAPY
  • RADIOTHERAPY
  • RECURRENCE
  • Radiation oncology
  • Radiology
  • Rectal carcinoma
  • Surgery
  • TARGET VOLUME DELINEATION

Cite this