This is the Scientific Surgery Archive, which contains all randomized clinical trials in surgery that have been identified by searching the top 50 English language medical journal issues since January 1998. Compiled by Jonothan J. Earnshaw, former Editor-in-Chief, BJS
Prediction of lateral pelvic node involvement in low rectal cancer by conventional computed tomography. BJS 2007; 94: 1014-1019.
Published: 16th April 2007
Authors: H. Yano, Y. Saito, E. Takeshita, O. Miyake, N. Ishizuka
Background
The clinical significance of lateral pelvic lymphatic spread in rectal cancer remains unknown. The present study aimed to assess the accuracy of preoperative computed tomography (CT) for prediction of lateral node involvement in patients with low rectal cancer and to determine the prognostic significance of extended lateral node dissection.
Method
A total of 109 patients with primary low rectal cancer were enrolled in this prospective cohort study. The preoperative CT findings were compared with the histopathological results and with follow‐up data.
Results
CT diagnosed lateral lymph node status with high accuracy (sensitivity 95 per cent, specificity 94 per cent), in marked contrast to mesorectal node status. Of 68 patients who had R0 resection without lateral node dissection, only two developed pelvic wall recurrence during median follow‐up of 4·1 years. Metastatic nodes in the lateral pelvic region were significantly larger than those in the mesorectum (P < 0·001).
Conclusion
CT accurately predicted lateral lymph node status in low rectal cancer, allowing preoperative identification of patients who might benefit from extended lateral node dissection. Copyright © 2007 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd.
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