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Metastasis to lateral lymph nodes with no mesenteric lymph node involvement in low rectal cancer: a retrospective case series
Yi Sun
Tianjin Union Medical Center
Corresponding Author
License:
This work is licensed under a CC BY 4.0 License. Read Full License
View the published version at World Journal of Surgical Oncology.
Purpose The aim of this study is to examine the pattern of lymph node metastasis (lateral vs. mesenteric lymph nodes) in low rectal cancer.
Methods This retrospective analysis included all patients undergoing laparoscopic total mesorectal excision plus lateral lymph node dissection for advanced low rectal cancer (up to 8 cm from the anal verge) during a period from July 1, 2017 to August 31, 2019 at the Department of Colorectal Surgery, Tianjin Union Medical Center. The decision to conduct lateral lymph node dissection was based on positive findings in preoperative imaging assessments.
Results A total of 42 patients were included in data analysis. Surgery was successfully completed as planned, without conversion to open surgery in any case. A minimal of 10 mesenteric lymph nodes and 1 lateral lymph node on each side were dissected in all patients. Pathologic examination of resected specimens showed no metastasis to either mesenteric or lateral lymph nodes in 7 (16.7%) case, metastasis to both mesenteric and lateral lymph nodes in 26 (61.9%) cases, metastasis to mesenteric but not lateral lymph nodes in 4 (9.5%) cases, and metastasis to lateral but not mesenteric lymph nodes in 5 (11.9%) cases (n=2 in the obturator region; n=3 in the iliac artery region).
Conclusion A clinically significant proportion of low rectal cancer patients have metastasis to lateral lymph nodes without involvement of mesenteric lymph nodes. More carefully planned prospective studies are needed to verify this preliminary finding.
Keywords
mesenteric lymph node metastasis, lateral lymph node metastasis
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This preprint is under consideration at World Journal of Surgical Oncology. A preprint is a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
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Research
Metastasis to lateral lymph nodes with no mesenteric lymph node involvement in low rectal cancer: a retrospective case series
Yi Sun
Tianjin Union Medical Center
Corresponding Author
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
Peer Review Timeline
CURRENT STATUS: Published
Published
On 06 Nov, 2020
No community comments so far
Editorial decision: Accept
On 26 Oct, 2020
Editor assigned
On 14 Oct, 2020
Submission checks complete
On 13 Oct, 2020
Editor invited
On 13 Oct, 2020
No comments provided
Editorial decision: Minor Revision
On 07 Oct, 2020
Reviewer #2 agreed
On 04 Oct, 2020
Review #2 received
Received 04 Oct, 2020
Editor assigned
On 01 Oct, 2020
Reviewers invited
Invitations sent on 01 Oct, 2020
Reviewer #1 agreed
On 01 Oct, 2020
Review #1 received
Received 01 Oct, 2020
Submission checks complete
On 30 Sep, 2020
Editor invited
On 30 Sep, 2020
No comments provided
Editorial decision: Major Revision
On 09 Sep, 2020
Review #5 received
Received 07 Sep, 2020
Review #2 received
Received 05 Sep, 2020
Review #4 received
Received 04 Sep, 2020
Review #1 received
Received 02 Sep, 2020
Review #3 received
Received 02 Sep, 2020
Reviewer #4 agreed
On 31 Aug, 2020
Reviewer #5 agreed
On 31 Aug, 2020
Reviewer #6 agreed
On 31 Aug, 2020
Reviewer #1 agreed
On 30 Aug, 2020
Reviewer #2 agreed
On 30 Aug, 2020
Reviewer #3 agreed
On 30 Aug, 2020
Editor assigned
On 27 Aug, 2020
Reviewers invited
Invitations sent on 27 Aug, 2020
Submission checks complete
On 26 Aug, 2020
Editor invited
On 26 Aug, 2020
Version 2
Posted 13 Aug, 2020
No comments provided
Editorial decision: Revise before peer review
On 20 Aug, 2020
Editor assigned
On 06 Aug, 2020
Submission checks complete
On 05 Aug, 2020
Editor invited
On 05 Aug, 2020
No comments provided
Editorial decision: Major Revision
On 06 Jul, 2020
Review #1 received
Received 02 Jul, 2020
Review #5 received
Received 28 Jun, 2020
Reviewer #17 agreed
On 25 Jun, 2020
Review #17 received
Received 25 Jun, 2020
Review #13 received
Received 25 Jun, 2020
Reviewer #16 agreed
On 25 Jun, 2020
Review #16 received
Received 25 Jun, 2020
Review #4 received
Received 25 Jun, 2020
Review #2 received
Received 25 Jun, 2020
Review #15 received
Received 24 Jun, 2020
Reviewer #15 agreed
On 24 Jun, 2020
Reviewer #14 agreed
On 23 Jun, 2020
Review #7 received
Received 22 Jun, 2020
Reviewer #13 agreed
On 20 Jun, 2020
Review #8 received
Received 18 Jun, 2020
Review #6 received
Received 18 Jun, 2020
Review #10 received
Received 18 Jun, 2020
Review #12 received
Received 18 Jun, 2020
Review #11 received
Received 18 Jun, 2020
Review #9 received
Received 18 Jun, 2020
Reviewer #6 agreed
On 17 Jun, 2020
Reviewer #7 agreed
On 17 Jun, 2020
Reviewer #8 agreed
On 17 Jun, 2020
Reviewer #9 agreed
On 17 Jun, 2020
Reviewer #10 agreed
On 17 Jun, 2020
Reviewer #11 agreed
On 17 Jun, 2020
Reviewer #12 agreed
On 17 Jun, 2020
Reviewer #4 agreed
On 16 Jun, 2020
Reviewer #5 agreed
On 16 Jun, 2020
Reviewer #3 agreed
On 11 Jun, 2020
Review #3 received
Received 11 Jun, 2020
Reviewer #2 agreed
On 10 Jun, 2020
Editor assigned
On 09 Jun, 2020
Reviewers invited
Invitations sent on 09 Jun, 2020
Reviewer #1 agreed
On 09 Jun, 2020
Submission checks complete
On 08 Jun, 2020
Editor invited
On 08 Jun, 2020
First submitted
On 04 Jun, 2020
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
License:
This work is licensed under a CC BY 4.0 License. Read Full License
View the published version at World Journal of Surgical Oncology.
Purpose The aim of this study is to examine the pattern of lymph node metastasis (lateral vs. mesenteric lymph nodes) in low rectal cancer.
Methods This retrospective analysis included all patients undergoing laparoscopic total mesorectal excision plus lateral lymph node dissection for advanced low rectal cancer (up to 8 cm from the anal verge) during a period from July 1, 2017 to August 31, 2019 at the Department of Colorectal Surgery, Tianjin Union Medical Center. The decision to conduct lateral lymph node dissection was based on positive findings in preoperative imaging assessments.
Results A total of 42 patients were included in data analysis. Surgery was successfully completed as planned, without conversion to open surgery in any case. A minimal of 10 mesenteric lymph nodes and 1 lateral lymph node on each side were dissected in all patients. Pathologic examination of resected specimens showed no metastasis to either mesenteric or lateral lymph nodes in 7 (16.7%) case, metastasis to both mesenteric and lateral lymph nodes in 26 (61.9%) cases, metastasis to mesenteric but not lateral lymph nodes in 4 (9.5%) cases, and metastasis to lateral but not mesenteric lymph nodes in 5 (11.9%) cases (n=2 in the obturator region; n=3 in the iliac artery region).
Conclusion A clinically significant proportion of low rectal cancer patients have metastasis to lateral lymph nodes without involvement of mesenteric lymph nodes. More carefully planned prospective studies are needed to verify this preliminary finding.