Mate Analysis of Comprehensive Treatmentstrategy for Advanced Rectal Cancer

Huaikun Ni; Ruolei Huang; Lianming Liao; Wenjuan Zhou

doi:doi:10.11648/j.ijcocr.20200504.13

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Mate Analysis of Comprehensive Treatmentstrategy for Advanced Rectal Cancer

Huaikun Ni, Ruolei Huang, Lianming Liao, Wenjuan Zhou

Published in International Journal of Clinical Oncology and Cancer Research (Volume 5, Issue 4)

Received: 3 November 2020 Accepted: 26 November 2020 Published: 4 December 2020

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Abstract

AIM: Objective to evaluate the clinical value of therapeutic lateral lymph node dissection in advanced rectal cancer after neoadjuvant radio-chemotherapy in patients with peritoneal retroperitoneum under MR suggesting perivascular iliac lymph node enlargement (lymph node diameter > 8mm). Methods: Because of this study is a retrospective study, the propensity to evaluate matching group is adopted to one group to Fujian Medical University Union Hospital, Fujian province hospital from January 2009 to June 2014 treated 103 cases of rectum MR images after neoadjuvant chemoradiation weeks iliac blood vessels have the progress of the lymph node enlargement period under peritoneal fold return rectal cancer line TME + therapeutic cases of lateral lymph node cleaning; In the group 2, 192 cases with the same tumor site, stage, type, gender and age as group 1 or similar were matched for the same period by propensity assessment, while the group 2 received TME only. The incidence of pelvic autonomic nerve injury after surgery, the 3-year local recurrence rate of pelvic cavity, and the 5-year tumor-free survival rate were compared between the two groups, so as to explore the clinical value of therapeutic periiliac dissection for advanced rectal cancer under peritoneal reflux. Results: The local recurrence rate of pelvic cavity in group 1 and group 2 was 2.91% (3/103) and 9.90% (19/192), respectively, 3 years after operation (P<0.05). Postoperative dysuria in group 1 and group 2 was 14.56% (15/103) and 5.21% (10/192), respectively, with significant difference (P<0.05). Postoperative sexual dysfunction in group 1 and group 2 was 12.50% (7/56) and 2.15% (2/93), respectively, with significant difference (P<0.05). The 5-year survival rates of group 1 and group 2 were 54.37% (56/103) and 51.56% (99/192), respectively, with no significant difference (P›0.05). The liver metastasis rates of group 1 and group 2 were 26.21% (27/103) and 29.17% (56/192), respectively. Lung metastasis rates in group 1 and group 2 were 19.41% (20/103) and 19.27% (37/192), respectively. Conclusion: After neoadjuvant chemoradiotherapy for advanced rectal cancer, selective lymphatic dissection along the iliac vessels guided by rectal magnetic resonance can reduce the local pelvic recurrence of patients for 3 years, but increase the probability of pelvic autonomic nerve injury, and periiliac lymph node dissection will not increase the 5-year survival rate of patients.

Published in	International Journal of Clinical Oncology and Cancer Research (Volume 5, Issue 4)
DOI	10.11648/j.ijcocr.20200504.13
Page(s)	93-104
Creative Commons	This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.
Copyright	Copyright © The Author(s), 2020. Published by Science Publishing Group

Keywords

Rectal Cancer, Progressive Stage, n-RCT, Lateral Lymph Node Dissection

References

[1]	Jayne DG, Thorpe HC, Copeland J, et al. Five-year follow-up of the Medical Research Council CLASICC trial of laparoscopically assisted versus open surgery for colorectal cancer [J]. Br J Surg, 2010, 97 (11): 1638-1645.
[2]	Hermanek P, Junginger T. The circumferential resection margin in rectal carcinoma surgery [J]. Tech Coloprotol, 2005, 26 (9): 193.
[3]	Hohenberger W, Weber K, Matzel K, et al. Standardized surgery for colonic cancer: complete mesocolic excision and central ligation-technical notes and outcome [J]. Colorectal Dis, 2009, 11 (4): 354-364.
[4]	Color II Study Group; Buunen M, Bonjer HJ, et al. COLOR II. A randomized clinical trial comparing laparoscopic and open surgery for rectal cancer [J]. Dan Med Bull 2009, 56 (2): 89-91.
[5]	Haboubi N. Colonic surgery for cancer: a new paradigm [J]. Colorectal Dis, 2009, 11 (4): 333-334.
[6]	Birgissona H, Talbackb M, Gunnarssona U, et al. Improved survival in cancer of the colon and rectum in Sweden [J]. Euro J Surg Oncol, 2005, 31 (8): 845-853.
[7]	Quirke P, Steele R, Monson J, et al. Effect of the plane of surgery achieved on local recurrence in patients with operable rectal cancer: a prospective study using data from the MRC CR07 and NCIC-CTG CO16 randomised clinical trial [J]. Lancet, 009, 373: 821-828.
[8]	Moriya Y. Treatment of lateral pelvic nodes metastases from rec-tal cancer: the future prospective [J]. G Chir, 2013, 34 (9- 10): 245-248.
[9]	Larson D, Marcello P, Larach S, et al. Surgeon Volume Does Not Predict Outcomes in the Setting of Technical Credentialing Results From a Randomized Trial in Colon Cancer [J]. Ann Surg, 2008, 248 (5): 746-750.
[10]	Pramateftakis M. Optimizing colonic cancer surgery: high ligation and complete mesocolic excision during right hemicolectomy [J]. Tech Coloproctol, 2010, 14 (1 suppl): 49-51.
[11]	Bertelsen C, Bols B, Ingeholm P, et al. Can the quality of colonic surgery be improved by standardisation of surgical technique with complete mesorectal excision? [J]. Colorectal Dis, 2011, 13 (10): 1123-1129.
[12]	Chen SL, Bilchik AJ. More extensive nodal dissection improves survival for stages I to III of colon cancer: a population based study [J]. Ann Surg, 2006, 244 (4): 602-610.
[13]	Nagawa H, Muto T, Sunouchi K, et al. Randomized, controlled trial of lateral node dissection vs. nerve- preserving resection in patients with rectal cancer after preoperative radiotherapy [J]. Dis Colon Rectum, 2001, 44 (9): 1274-1280.
[14]	den Dulk M, van de Velde C. Quality assurance in surgical oncology: the tale of the Dutch rectal cancer TEM trial [J]. J Surg Oncol, 2008, 97 (1): 5-7.
[15]	Sammour T, Chang GJ. Lateral node dissection in low rectal cancer: Time for a global approach?[J]. Ann Surg, 2017, 266 (2): 208-209.
[16]	Akiyoshi T, Ueno M, Matsueda K, et al. Selective lateral pelvic lymph node dissection in patients with advanced low rectal cancer treated with preoperative chemoradiotherapy based on pretreatment imaging [J]. Ann Surg Oncol, 2014, 21 (1): 189-196.
[17]	Al-Sukhni E, Milot L, Fruitman M, et al. Diagnostic accuracy of MRI for assessment of T category, lymph node metastases, and circumferential resection margin involvement in patients with rectal cancer: A systematic review and meta-analysis [J]. Ann Surg Oncol, 2012, 19 (7): 2212-2223.
[18]	Sun lingyu et al. Precise stratified treatment strategy for rectal cancer based on 2017ESMO guidelines, 27.08.2017
[19]	Li XT, Sun YS, Tang L, et al. Evaluating local lymph node metastasis with magnetic resonance imaging, endoluminal ultrasound and computed tomography in rectal cancer: A meta-analysis [J]. Colorectal Dis, 2015, 17 (6): 129-135.
[20]	Ishibe A, Ota M, Watanabe J, et al. Prediction of lateral pelvic lymph-node metastasis in low rectal cancer by magnetic resonance imaging [J]. World J Surg, 2016, 40 (4): 995-1001.
[21]	Horne J, Bateman AC, Carr NJ, et al. Lymph node revealing solutions in colorectal cancer: should they be used routinely? [J]. J Clin Pathol, 2014, 67 (5): 383-388.
[22]	Brown G, Richards CJ, Bourne MW, et al. Morphologic predic- tors of lymph node status in rectal cancer with use of high-spatial-resolution MR imaging with histopathologic comparison [J]. Radiology, 2003, 227 (2): 371-377.
[23]	Ye Y, Liu T, Lu L, et al. Pre-operative TNM staging of primary colorectal cancer by (18) F-FDG PET-CT or PET: A meta-analysis including 2283 patients [J]. Int J Clin Exp Med, 2015, 8 (11): 21773-21785.
[24]	Lee JY, Yoon SM, Kim JT, et al. Diagnostic and prognostic value of preoperative (18) F-fluorodeoxyglucose positron emission tomography/computed tomography for colorectal cancer: comparison with conventional computed tomography [J]. Intest Res, 2017, 15 (2): 208-214.
[25]	Padhani AR, Liu GY, Mu- Koh D, et al. Diffusion- weighted magnetic resonance imaging as a cancer biomarker: consensus and recommendations [J]. Neoplasia, 2009, 11 (2): 102-125.
[26]	Mizukami Y, Ueda S, Mizumoto A, et al. Diffusion- weighted magnetic resonance imaging for detecting lymph node metastasis of rectal cancer [J]. World J Surg, 2011, 35 (4): 895-899.
[27]	Kinugasa T, Akagi Y, Ochi T, et al. Lateral lymph-node dissection for rectal cancer: meta-analysis of all 944 cases undergoing surgery during 1975-2004 [J]. Anticancer Res, 2013, 33 (7): 2921-2927.
[28]	Ueno M, Oya M, Azekura K, et al. Incidence and prognosticsignificance of lateral lymph node metastasis in patients with advanced low rectal cancer [J]. Br J Surg, 2005, 92 (6): 756-763.
[29]	MERCURY Study Group, Shihab OC, Taylor F, et al. Relevance of magnetic resonance imaging-detected pelvic sidewall lymph node involvement in rectal cancer [J]. Br J Surg, 2 011, 98 (12): 1798-1804.
[30]	Ogawa S, Hida JI, Ike H, et al. The important risk factor for lateral pelvic lymph node metastasis of lower rectal cancer is node-positive status on magnetic resonance imaging: study of the Lymph Node Committee of Japanese Society for Cancer of the Colon and Rectum [J]. Int J Colorectal Dis, 2016, 31 (10): 1719-1728.
[31]	Ogawa S, Hida JI, Ike H, et al. Prediction of lateral pelvic lymph node metastasis from lower rectal cancer using magnetic resonance imaging and risk factors for metastasis: Multicenter study of the Lymph Node Committee of the Japanese Society for Cancer of the Colon and Rectum [J]. Int J Colorectal Dis, 2017, 32 (10): 1479-1487.
[32]	Gillies RJ, Kinahan PE, Hricak H. Radiomics: Images are more than pictures, they are data [J]. Radiology, 2016, 278 (2): 563-577.
[33]	Parekh V, Jacobs MA. Radiomics: A new application from established techniques [J]. Expert Rev Precis Med Drug Dev, 2016, 1 (2): 207-226.
[34]	Huang YQ, Liang CH, He L, et al. Development and validation of a radiomics nomogram for preoperative prediction of lymph node metastasis in colorectal cancer [J]. J Clin Oncol, 2016, 34 (4): 2157-2164.
[35]	Klang E. Deep learning and medical imaging [J]. J Thorac Dis, 2018, 10 (3): 1325-1328.
[36]	Takahashi T, Ueno M, Azekura K, et al. Lateral node dissection and total mesorectal excision for rectal cancer [J]. Dis Colon Rectum, 2000, 43 (10): s59-s68.
[37]	Yano H, Moran BJ. The incidence of lateral pelvic side all nodal involvement in low rectal cancer may be similar in Japan and the West [J]. Br J Surg, 2010, 95 (1): 33-49.
[38]	Ryoma Y, Yoshifumi S, Hitoshi K, et al. Clinical significance of extramural tumor deposits in the lateral pelvic lymph node area in low rectal cancer: A retrospective study at two institutions [J]. Ann Surg Oncol, 2016, 23 (4): 552-558.
[39]	Song JH, Jeong JU, Lee JH, et al. Preoperative chemoradiotherapy versus postoperative chemoradiotherapy for stage II-III resectable rectal cancer: A meta-analysis of randomized controlle trials [J]. Radiat Oncol J, 2017, 35 (3): 198-207.
[40]	Ishibe A, Ota M, Watanabe J, et al. Prediction of lateral pelvic lymph-node metastasis in low rectal cancer by magnetic resonance imaging [J]. World J Surg, 2015, 40 (4): 1-7.
[41]	Ishihara S, Kawai K, Tanaka T, et al. Oncological outcomes of lateral pelvic lymph node metastasis in rectal cancer treated with preoperative chemoradiotherapy [J]. Dis Colon Rectum, 2017, 60 (5): 469-476.
[42]	Fujita S, Mizusawa J, Kanemitsu Y, et al. Mesorectal excision with or without lateral lymph node dissection for clinical stage II/III lower rectal cancer (JCOG0212) [J]. Ann Surg, 2017, 266 (2): 201-207.
[43]	Sauer R, Becker H, Hohenberger W, et al. Preoperative versus postoperative chemoradiotherapy for rectal cancer. [J]. N Engl J Med, 2004, 351 (17): 1731-1740.
[44]	Sauer R, Liersch T, Merkel S, et al. Preoperative versus postoperative chemoradiotherapy for locally advanced rectal cancer: results of the German CAO/ARO/AIO-94 randomized phase III trial after a median follow- up of 11 years [J]. J Clin Oncol, 2012, 30 (16): 1926-1933.
[45]	Mallick S, Benson R, Haresh KP, et al. Neoadjuvant treatment intensification or adjuvant chemotherapy for locally advanced carcinoma rectum: The optimum treatment approach remains unresolved [J]. J Egypt Natl Canc Inst, 2015, 27 (4): 179-185.
[46]	Stefano AD, Moretto R, Bucci L, et al. Adjuvant treatment for locally advanced rectal cancer patients after preoperative chemoradiotherapy: when, and for whom? [J]. Clin Colorectal Cancer, 2014, 13 (3): 185-191.
[47]	Fujita S, Saito S, Moriya Y, et al. Postoperative morbidity andmortality after mesorectal excision with and without lateral lymph node dissection for clinical stage II or stage III lower rectal cancer (JCOG0212): results from a multicentre, randomised controlled, non-inferiority trial [J]. Lancet Oncol, 2012, 13 (6): 616-621.
[48]	Akasu T, Iinuma G, Takawa M, et al. Accuracy of high resoluion magnetic resonance imaging in preoperative staging of rectal cancer [J]. Ann Surg Oncol, 2009, 16 (10): 2787-2794.2017, 25 (11): 801-806.
[49]	Kim MJ, Kim TH, Kim DY, et al. Can chemoradiation allow for omission of lateral pelvic node dissection for locally advanced rectal cancer? [J]. J Surg Oncol, 2015, 111 (4): 459-464.
[50]	Oh HK, Kang SB, Lee SM, et al. Neoadjuvantchemoradiotherapy affects the indications for lateral pelvic node dissection in mid/low rectal cancer with clinically suspected lateral node involvement: a multicenter retrospective cohort study [J]. AnnSurg Oncol, 2014, 21 (7): 2280-2287.
[51]	Akiyoshi T, Matsueda K, sHiratsuka M, et al. Indications for lateral pelvic lymph node dissection based on magnetic resonan ceimaging before and after preoperative chemoradiotherapy in patients with advanced low-rectal cancer [J]. Ann Surg Oncol, 2015, 22 (suppl3): 614-620.
[52]	Ogura A, Akiyoshi T, Nagasaki T, et al. Feasibility of laparoscopic total mesorectal excision with extended lateral pelvic lymph node dissectionfor advanced lower rectal cancer after preoperative chemoradiotherapy [J]. World J Surg, 2017, 41 (3): 868-875.
[53]	Akasu T, Sugihara K, Moriya Y. Male urinary and sexual functions after mesorectal excision alone or in combination with extended lateral pelvic lymph node dissection for rectal cancer [J]. Ann Surg Oncol, 2009, 16 (10): 2779-2786.
[54]	Col C, Hasdemir O, Yalcin E, et al. The assessment of urinary function following extended lymph node dissection for colorectal cancer [J]. Eur J Surg Oncol, 2005, 31 (3): 237-241.
[55]	Fujita S, Yamamoto S, Akasu T, Moriya Y. Lateral pelvic lymph node dissection for advanced lower rectal cancer [J]. Br J Surg, 2003, 90 (12): 1580-1585.
[56]	Fujita S, Akasu T, Mizusawa J, et al. Postoperative morbidity andmortality after mesorectal excision with and without lateral lymph node dissection for clinical stage II or stage III lower rectal cancer (JCOG0212): results from a multicentre, randomised controlled, non-inferiority trial [J]. Lancet Oncol, 2012, 13 (6): 616-621.
[57]	Hasdemir O, Col C, Yalcin E, et al. Local recurrence and survival rates after extended systematic lymph-node dissection for surgical treatment of rectal cancer [J]. Hepatogastroenterology, 2005, 52 (62): 455-459.
[58]	Kim JC, Takahashi K, Yu CS, et al. Comparative outcome between chemoradiotherapy and lateral pelvic lymph node dissection following total mesorectal excision in rectal cancer [J]. Ann Surg, 2007, 246 (5): 754-762.
[59]	Kobayashi H, Mochizuki H, Kato T, et al. Outcomes of surgery alone for lower rectal cancer with and without pelvic sidewall dissection [J]. Dis Colon Rectum, 2009, 52 (4): 567-576.
[60]	Kusters M, Beets GL, van de Velde CJ, et al. A comparison between the treatment of low rectal cancer in Japan and the Netherlands, focusing on the patterns of local recurrence [J]. Ann Surg, 2009, 249 (2): 229-235.
[61]	Kyo K, Sameshima S, Takahashi M, et al. Impact of autonomic nerve preservation and lateral node dissection on male urogenital function after total mesorectal excision for lower rectal cancer [J]. World J Surg, 2006, 30 (6): 1014-1019.
[62]	Matsuoka H, Masaki T, Sugiyama M, et al. Impact of lateral pelvic lymph node dissection on evacuatory and urinary functions following low anterior resection for advanced rectal carcinoma [J]. Langenbecks Arch Surg, 2005, 390 (6): 517-522.
[63]	Saito S, Fujita S, Mizusawa J, et al. Male sexual dysfunction after rectal cancer surgery: Results of a randomized trial comparing mesorectal excision with and without lateral lymph node dissection for patients with lower rectal cancer: Japan Clinical Oncology Group Study JCOG0212 [J]. Eur J Surg Oncol, 2016, 42 (12): 1851-1858.
[64]	Watanabe T, Muro K, Ajioka Y, et al. Japanese Society for Cancer of the Colon and Rectum (JSCCR) guidelines 2016 for the treatment of colorectal cancer [J]. Int J Clin Oncol, 2018, 23 (1): 1-34.
[65]	Watanabe T, Tsurita G, Muto T, et al. Extended lymphadenectomy and preoperative radiotherapy for lower rectal cancers [J]. Surgery, 2002, 132 (1): 27-33.
[66]	Sugihara K, Kobayashi H, Kato T, et al. Indication and benefit of pelvic sidewall dissection for rectal cancer [J]. Dis Colon Rectum, 2006, 49 (11): 1663-1672.
[67]	Akiyoshi T, Watanabe T, Miyata S, et al. Results of a Japanese Nationwide Multi-Institutional Study on Lateral Pelvic Lymph Node Metastasis in Low Rectal Cancer: Is It Regional or Distant Disease? [J]. Annals of Surgery, 2012, 255 (6): 1129-1134.
[68]	Ogawa S, Itabashi M, Hirosawa T, et al. Lateral pelvic lymph node dissection can be omitted in lower rectal cancer in which the longest lateral pelvic and perirectal lymph node is less than 5 mm on MRI [J]. J Surg Oncol, 2014, 109 (3): 227-233.
[69]	H Sato, K Maeda, M Maruta, et al. Who Can Get the Beneficial Effect from Lateral Lymph Node Dissection for Dukes C Rectal Carcinoma Below the Peritoneal Reﬂection? [J]. Dis Colon Rectum, 2006, 49 (10 Suppl): S3-S12.
[70]	van der Pas MH, Haglind E, Cuesta MA, et al. Laparoscopic versus open surgery for rectal cancer (COLOR II): short-term outcomes of a randomised, phase 3 trial [J]. Lancet Oncol, 2013, 14 (3): 210-218.
[71]	Bonjer HJ, Deijen CL, Abis GA, et al. A randomized trial of laparoscopic versus open surgery for rectal cancer [J]. N Engl J Med, 2015, 372 (14): 1324-1332.
[72]	Liang JT. Technical feasibility of laparoscopic lateral pelvic lymph node dissection for patients with low rectal cancer after concurrent chemoradiation therapy [J]. Ann Surg Oncol, 2011, 18 (1): 153-159.
[73]	Nagayoshi K, Ueki T, Manabe T, et al. Laparoscopic lateral pelvic lymph node dissection is achievable and offers advantages as a minimally invasive surgery over the open approach [J]. Surg Endosc, 2016, 30 (5): 1938-1947.
[74]	Furuhata T, Okita K, Nishidate T, et al. Clinical feasibility of laparoscopic lateral pelvic lymph node dissection following total mesorectal excision for advanced rectal cancer [J]. Surg Today, 2015, 45 (3): 310-314.
[75]	Hojo K, Vernava AM, Sugihara K, et al. Preservation of urine voiding and sexual function after rectal cancer surgery [J]. Dis Colon Rectum, 1991, 34 (7): 532-539.
[76]	Moriya Y, Sugihara K, Akasu T, et al. Nerve-sparing surgery with lateral node dissection for advanced lower rectal cancer [J]. Eur J Cancer, 1995, 31A (7-8): 1229-1232.

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Huaikun Ni, Ruolei Huang, Lianming Liao, Wenjuan Zhou. (2020). Mate Analysis of Comprehensive Treatmentstrategy for Advanced Rectal Cancer. International Journal of Clinical Oncology and Cancer Research, 5(4), 93-104. https://doi.org/10.11648/j.ijcocr.20200504.13

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Huaikun Ni; Ruolei Huang; Lianming Liao; Wenjuan Zhou. Mate Analysis of Comprehensive Treatmentstrategy for Advanced Rectal Cancer. Int. J. Clin. Oncol. Cancer Res. 2020, 5(4), 93-104. doi: 10.11648/j.ijcocr.20200504.13

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Huaikun Ni, Ruolei Huang, Lianming Liao, Wenjuan Zhou. Mate Analysis of Comprehensive Treatmentstrategy for Advanced Rectal Cancer. Int J Clin Oncol Cancer Res. 2020;5(4):93-104. doi: 10.11648/j.ijcocr.20200504.13

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@article{10.11648/j.ijcocr.20200504.13,
  author = {Huaikun Ni and Ruolei Huang and Lianming Liao and Wenjuan Zhou},
  title = {Mate Analysis of Comprehensive Treatmentstrategy for Advanced Rectal Cancer},
  journal = {International Journal of Clinical Oncology and Cancer Research},
  volume = {5},
  number = {4},
  pages = {93-104},
  doi = {10.11648/j.ijcocr.20200504.13},
  url = {https://doi.org/10.11648/j.ijcocr.20200504.13},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ijcocr.20200504.13},
  abstract = {AIM: Objective to evaluate the clinical value of therapeutic lateral lymph node dissection in advanced rectal cancer after neoadjuvant radio-chemotherapy in patients with peritoneal retroperitoneum under MR suggesting perivascular iliac lymph node enlargement (lymph node diameter > 8mm). Methods: Because of this study is a retrospective study, the propensity to evaluate matching group is adopted to one group to Fujian Medical University Union Hospital, Fujian province hospital from January 2009 to June 2014 treated 103 cases of rectum MR images after neoadjuvant chemoradiation weeks iliac blood vessels have the progress of the lymph node enlargement period under peritoneal fold return rectal cancer line TME + therapeutic cases of lateral lymph node cleaning; In the group 2, 192 cases with the same tumor site, stage, type, gender and age as group 1 or similar were matched for the same period by propensity assessment, while the group 2 received TME only. The incidence of pelvic autonomic nerve injury after surgery, the 3-year local recurrence rate of pelvic cavity, and the 5-year tumor-free survival rate were compared between the two groups, so as to explore the clinical value of therapeutic periiliac dissection for advanced rectal cancer under peritoneal reflux. Results: The local recurrence rate of pelvic cavity in group 1 and group 2 was 2.91% (3/103) and 9.90% (19/192), respectively, 3 years after operation (P<0.05). Postoperative dysuria in group 1 and group 2 was 14.56% (15/103) and 5.21% (10/192), respectively, with significant difference (P<0.05). Postoperative sexual dysfunction in group 1 and group 2 was 12.50% (7/56) and 2.15% (2/93), respectively, with significant difference (P<0.05). The 5-year survival rates of group 1 and group 2 were 54.37% (56/103) and 51.56% (99/192), respectively, with no significant difference (P›0.05). The liver metastasis rates of group 1 and group 2 were 26.21% (27/103) and 29.17% (56/192), respectively. Lung metastasis rates in group 1 and group 2 were 19.41% (20/103) and 19.27% (37/192), respectively. Conclusion: After neoadjuvant chemoradiotherapy for advanced rectal cancer, selective lymphatic dissection along the iliac vessels guided by rectal magnetic resonance can reduce the local pelvic recurrence of patients for 3 years, but increase the probability of pelvic autonomic nerve injury, and periiliac lymph node dissection will not increase the 5-year survival rate of patients.},
 year = {2020}
}

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TY  - JOUR
T1  - Mate Analysis of Comprehensive Treatmentstrategy for Advanced Rectal Cancer
AU  - Huaikun Ni
AU  - Ruolei Huang
AU  - Lianming Liao
AU  - Wenjuan Zhou
Y1  - 2020/12/04
PY  - 2020
N1  - https://doi.org/10.11648/j.ijcocr.20200504.13
DO  - 10.11648/j.ijcocr.20200504.13
T2  - International Journal of Clinical Oncology and Cancer Research
JF  - International Journal of Clinical Oncology and Cancer Research
JO  - International Journal of Clinical Oncology and Cancer Research
SP  - 93
EP  - 104
PB  - Science Publishing Group
SN  - 2578-9511
UR  - https://doi.org/10.11648/j.ijcocr.20200504.13
AB  - AIM: Objective to evaluate the clinical value of therapeutic lateral lymph node dissection in advanced rectal cancer after neoadjuvant radio-chemotherapy in patients with peritoneal retroperitoneum under MR suggesting perivascular iliac lymph node enlargement (lymph node diameter > 8mm). Methods: Because of this study is a retrospective study, the propensity to evaluate matching group is adopted to one group to Fujian Medical University Union Hospital, Fujian province hospital from January 2009 to June 2014 treated 103 cases of rectum MR images after neoadjuvant chemoradiation weeks iliac blood vessels have the progress of the lymph node enlargement period under peritoneal fold return rectal cancer line TME + therapeutic cases of lateral lymph node cleaning; In the group 2, 192 cases with the same tumor site, stage, type, gender and age as group 1 or similar were matched for the same period by propensity assessment, while the group 2 received TME only. The incidence of pelvic autonomic nerve injury after surgery, the 3-year local recurrence rate of pelvic cavity, and the 5-year tumor-free survival rate were compared between the two groups, so as to explore the clinical value of therapeutic periiliac dissection for advanced rectal cancer under peritoneal reflux. Results: The local recurrence rate of pelvic cavity in group 1 and group 2 was 2.91% (3/103) and 9.90% (19/192), respectively, 3 years after operation (P<0.05). Postoperative dysuria in group 1 and group 2 was 14.56% (15/103) and 5.21% (10/192), respectively, with significant difference (P<0.05). Postoperative sexual dysfunction in group 1 and group 2 was 12.50% (7/56) and 2.15% (2/93), respectively, with significant difference (P<0.05). The 5-year survival rates of group 1 and group 2 were 54.37% (56/103) and 51.56% (99/192), respectively, with no significant difference (P›0.05). The liver metastasis rates of group 1 and group 2 were 26.21% (27/103) and 29.17% (56/192), respectively. Lung metastasis rates in group 1 and group 2 were 19.41% (20/103) and 19.27% (37/192), respectively. Conclusion: After neoadjuvant chemoradiotherapy for advanced rectal cancer, selective lymphatic dissection along the iliac vessels guided by rectal magnetic resonance can reduce the local pelvic recurrence of patients for 3 years, but increase the probability of pelvic autonomic nerve injury, and periiliac lymph node dissection will not increase the 5-year survival rate of patients.
VL  - 5
IS  - 4
ER  -

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Author Information

Huaikun Ni

General Surgery Department, Fujian Provincial Hospital South Branch, Fuzhou, China
Ruolei Huang

General Surgery Department, Fujian Provincial Hospital South Branch, Fuzhou, China
Lianming Liao

Central Laboratory, Union Hospital Affiliated to Fujian Medical University, Fuzhou, China
Wenjuan Zhou

Central Laboratory, Union Hospital Affiliated to Fujian Medical University, Fuzhou, China

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Huaikun Ni, Ruolei Huang, Lianming Liao, Wenjuan Zhou. (2020). Mate Analysis of Comprehensive Treatmentstrategy for Advanced Rectal Cancer. International Journal of Clinical Oncology and Cancer Research, 5(4), 93-104. https://doi.org/10.11648/j.ijcocr.20200504.13

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Huaikun Ni; Ruolei Huang; Lianming Liao; Wenjuan Zhou. Mate Analysis of Comprehensive Treatmentstrategy for Advanced Rectal Cancer. Int. J. Clin. Oncol. Cancer Res. 2020, 5(4), 93-104. doi: 10.11648/j.ijcocr.20200504.13

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Huaikun Ni, Ruolei Huang, Lianming Liao, Wenjuan Zhou. Mate Analysis of Comprehensive Treatmentstrategy for Advanced Rectal Cancer. Int J Clin Oncol Cancer Res. 2020;5(4):93-104. doi: 10.11648/j.ijcocr.20200504.13

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@article{10.11648/j.ijcocr.20200504.13,
  author = {Huaikun Ni and Ruolei Huang and Lianming Liao and Wenjuan Zhou},
  title = {Mate Analysis of Comprehensive Treatmentstrategy for Advanced Rectal Cancer},
  journal = {International Journal of Clinical Oncology and Cancer Research},
  volume = {5},
  number = {4},
  pages = {93-104},
  doi = {10.11648/j.ijcocr.20200504.13},
  url = {https://doi.org/10.11648/j.ijcocr.20200504.13},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ijcocr.20200504.13},
  abstract = {AIM: Objective to evaluate the clinical value of therapeutic lateral lymph node dissection in advanced rectal cancer after neoadjuvant radio-chemotherapy in patients with peritoneal retroperitoneum under MR suggesting perivascular iliac lymph node enlargement (lymph node diameter > 8mm). Methods: Because of this study is a retrospective study, the propensity to evaluate matching group is adopted to one group to Fujian Medical University Union Hospital, Fujian province hospital from January 2009 to June 2014 treated 103 cases of rectum MR images after neoadjuvant chemoradiation weeks iliac blood vessels have the progress of the lymph node enlargement period under peritoneal fold return rectal cancer line TME + therapeutic cases of lateral lymph node cleaning; In the group 2, 192 cases with the same tumor site, stage, type, gender and age as group 1 or similar were matched for the same period by propensity assessment, while the group 2 received TME only. The incidence of pelvic autonomic nerve injury after surgery, the 3-year local recurrence rate of pelvic cavity, and the 5-year tumor-free survival rate were compared between the two groups, so as to explore the clinical value of therapeutic periiliac dissection for advanced rectal cancer under peritoneal reflux. Results: The local recurrence rate of pelvic cavity in group 1 and group 2 was 2.91% (3/103) and 9.90% (19/192), respectively, 3 years after operation (P<0.05). Postoperative dysuria in group 1 and group 2 was 14.56% (15/103) and 5.21% (10/192), respectively, with significant difference (P<0.05). Postoperative sexual dysfunction in group 1 and group 2 was 12.50% (7/56) and 2.15% (2/93), respectively, with significant difference (P<0.05). The 5-year survival rates of group 1 and group 2 were 54.37% (56/103) and 51.56% (99/192), respectively, with no significant difference (P›0.05). The liver metastasis rates of group 1 and group 2 were 26.21% (27/103) and 29.17% (56/192), respectively. Lung metastasis rates in group 1 and group 2 were 19.41% (20/103) and 19.27% (37/192), respectively. Conclusion: After neoadjuvant chemoradiotherapy for advanced rectal cancer, selective lymphatic dissection along the iliac vessels guided by rectal magnetic resonance can reduce the local pelvic recurrence of patients for 3 years, but increase the probability of pelvic autonomic nerve injury, and periiliac lymph node dissection will not increase the 5-year survival rate of patients.},
 year = {2020}
}

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TY  - JOUR
T1  - Mate Analysis of Comprehensive Treatmentstrategy for Advanced Rectal Cancer
AU  - Huaikun Ni
AU  - Ruolei Huang
AU  - Lianming Liao
AU  - Wenjuan Zhou
Y1  - 2020/12/04
PY  - 2020
N1  - https://doi.org/10.11648/j.ijcocr.20200504.13
DO  - 10.11648/j.ijcocr.20200504.13
T2  - International Journal of Clinical Oncology and Cancer Research
JF  - International Journal of Clinical Oncology and Cancer Research
JO  - International Journal of Clinical Oncology and Cancer Research
SP  - 93
EP  - 104
PB  - Science Publishing Group
SN  - 2578-9511
UR  - https://doi.org/10.11648/j.ijcocr.20200504.13
AB  - AIM: Objective to evaluate the clinical value of therapeutic lateral lymph node dissection in advanced rectal cancer after neoadjuvant radio-chemotherapy in patients with peritoneal retroperitoneum under MR suggesting perivascular iliac lymph node enlargement (lymph node diameter > 8mm). Methods: Because of this study is a retrospective study, the propensity to evaluate matching group is adopted to one group to Fujian Medical University Union Hospital, Fujian province hospital from January 2009 to June 2014 treated 103 cases of rectum MR images after neoadjuvant chemoradiation weeks iliac blood vessels have the progress of the lymph node enlargement period under peritoneal fold return rectal cancer line TME + therapeutic cases of lateral lymph node cleaning; In the group 2, 192 cases with the same tumor site, stage, type, gender and age as group 1 or similar were matched for the same period by propensity assessment, while the group 2 received TME only. The incidence of pelvic autonomic nerve injury after surgery, the 3-year local recurrence rate of pelvic cavity, and the 5-year tumor-free survival rate were compared between the two groups, so as to explore the clinical value of therapeutic periiliac dissection for advanced rectal cancer under peritoneal reflux. Results: The local recurrence rate of pelvic cavity in group 1 and group 2 was 2.91% (3/103) and 9.90% (19/192), respectively, 3 years after operation (P<0.05). Postoperative dysuria in group 1 and group 2 was 14.56% (15/103) and 5.21% (10/192), respectively, with significant difference (P<0.05). Postoperative sexual dysfunction in group 1 and group 2 was 12.50% (7/56) and 2.15% (2/93), respectively, with significant difference (P<0.05). The 5-year survival rates of group 1 and group 2 were 54.37% (56/103) and 51.56% (99/192), respectively, with no significant difference (P›0.05). The liver metastasis rates of group 1 and group 2 were 26.21% (27/103) and 29.17% (56/192), respectively. Lung metastasis rates in group 1 and group 2 were 19.41% (20/103) and 19.27% (37/192), respectively. Conclusion: After neoadjuvant chemoradiotherapy for advanced rectal cancer, selective lymphatic dissection along the iliac vessels guided by rectal magnetic resonance can reduce the local pelvic recurrence of patients for 3 years, but increase the probability of pelvic autonomic nerve injury, and periiliac lymph node dissection will not increase the 5-year survival rate of patients.
VL  - 5
IS  - 4
ER  -

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