TY - JOUR
T1 - Lateral Lymph Nodes in Rectal Cancer
T2 - Do we all Think the Same? A Review of Multidisciplinary Obstacles and Treatment Recommendations
AU - Sluckin, Tania C
AU - Couwenberg, Alice M
AU - Lambregts, Doenja M J
AU - Hazen, Sanne-Marije J A
AU - Horsthuis, Karin
AU - Meijnen, Philip
AU - Beets-Tan, Regina G H
AU - Tanis, Pieter J
AU - Marijnen, Corrie A M
AU - Kusters, Miranda
N1 - Copyright © 2022. Published by Elsevier Inc.
PY - 2022/6
Y1 - 2022/6
N2 - 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.
AB - 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.
KW - CHEMORADIATION
KW - COMPARING MESORECTAL EXCISION
KW - DISSECTION
KW - LYMPHADENECTOMY
KW - METASTASIS
KW - Multidisciplinary team
KW - NODAL DISEASE
KW - PREOPERATIVE CHEMORADIOTHERAPY
KW - RADIOTHERAPY
KW - RECURRENCE
KW - Radiation oncology
KW - Radiology
KW - Rectal carcinoma
KW - Surgery
KW - TARGET VOLUME DELINEATION
U2 - 10.1016/j.clcc.2022.02.002
DO - 10.1016/j.clcc.2022.02.002
M3 - (Systematic) Review article
C2 - 35339391
SN - 1533-0028
VL - 21
SP - 80
EP - 88
JO - Clinical Colorectal Cancer
JF - Clinical Colorectal Cancer
IS - 2
ER -