ADVERTISEMENT
No Long-Term Improvement With Lateral Lymph Node Dissection for Rectal Cancer
Lateral lymph node dissection (LLND) did not improve long-term outcomes in patients with rectal cancer and was tied to increased urinary dysfunction and male sexual dysfunction, according to findings from a review and meta-analysis (Asian J Surg. 2020 Jan 9. Epub ahead of print).
“Lateral lymph node metastasis in rectal cancer was first reported in the 1950s, since then, there has been an on-going debate about the value of…LLND…in the management of rectal cancer,” said Peilan Ma, MD, General Surgery Clinical Medical Center, Gansu Provincial Hospital, Lanzhou, China, and colleagues.
Thus, Dr Ma et al conducted a systematic review and meta-analysis of LLND for rectal cancer. Using PubMed, Embase, Cochrane Library, Web of Science, and Google Scholar databases, they gathered clinical trial data comparing LLND and non-LLND in patients with rectal cancer from inception to 2019.
Ultimately, data for 26 studies including 6865 patients were collected and analyzed for outcome measures including 5-year survival rate, recurrence rate, perioperative outcomes, urinary function, and sexual function.
The meta-analysis showed that, with regard to efficacy, there was no difference in 5-year disease-free survival rate and local recurrences between the 2 groups (hazard ratio, 1.07; 95% CI, 0.89-1.28; P = .496 and odds ratio [OR], 0.90; 95% CI, 0.76-1.06; P = .208).
Vis-à-vis safety, the incidence of urinary and sexual dysfunction was significantly higher among patients who underwent LLND compared with those who did not (OR, 2.14; 95% CI, 1.21-3.79; P = .009 and OR, 4.19; 95% CI, 1.55-11.33; P = .005).
“In conclusion, LLND did not improve the long-term prognosis of patients with rectal cancer, and was associated with increased urinary dysfunction and male sexual dysfunction,” Dr Ma and colleagues concluded.—Hina Porcelli
