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Review
. 2021 Aug 9;5(6):731-737.
doi: 10.1002/ags3.12490. eCollection 2021 Nov.

From "East vs West" towards international multidisciplinary collaboration: An appraisal of lateral lymph nodes in rectal cancer

Tania C Sluckin  1 , Sanne-Marije J A Hazen  1 , Miranda Kusters  1
Affiliations
Review

From "East vs West" towards international multidisciplinary collaboration: An appraisal of lateral lymph nodes in rectal cancer

Tania C Sluckin et al. Ann Gastroenterol Surg. .

Abstract

Western and Eastern practices have traditionally differed in their approach to treating lateral lymph nodes in rectal cancer. While Western clinicians have primarily favored neoadjuvant (chemo)radiotherapy to sterilize lateral compartments, Eastern physicians have often opted for the surgical removed of lymphatic tissue with a lateral lymph node dissection without neoadjuvant treatment. The literature suggests similar oncological outcomes for these two separate techniques, while tangible differences exist. The combination of these paradigms may be beneficial in reducing overall morbidity while sustaining low recurrence rates. This article considers traditional Eastern and Western perspectives, discusses nodal features important for predicting malignancy and attempts to stimulate international, multidisciplinary consensus and collaboration.

Keywords: lateral lymph node dissection; lateral lymph nodes; neoadjuvant treatment.

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Conflict of interest statement

Funding: No funding was received. Conflict of interest: The authors declare no conflicts of interests for this article. Author Contribution: All authors contributed substantially to the conception, creation and interpretation of this work and were involved in drafting and revising it critically. Each author approved the final version to be published and agree to be accountable for all aspects of the work.

Figures

FIGURE 1
FIGURE 1
Lateral lymph node compartments. A–D: Caudal progression through a T2‐MRI. Red: external iliac compartment surrounding the externa iliac vessels. Green: obturator compartment located lateral of the lateral border of the internal iliac artery (brown spot) and caudal of when the internal iliac artery exits the pelvis. Blue: internal iliac compartment located medial of the lateral border of the internal iliac artery (brown spot). Orange arrows indicate lateral lymph nodes
See this image and copyright information in PMC

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