Research progress in lateral lymph node dissection for rectal cancer

TL;DR

This paper reviews the role of lateral lymph node dissection in treating rectal cancer, comparing its use in Japan with neoadjuvant therapy in Europe and North America.

Contribution

The paper provides an updated analysis of LLND's clinical efficacy and controversies, offering insights for its optimal application.

Findings

LLND is a standard procedure in Japan for low rectal cancer.

Neoadjuvant chemoradiotherapy is preferred in Europe and North America.

The paper highlights ongoing debates and future directions for LLND.

Abstract

Lateral lymph node dissection (LLND), a critical surgical intervention for patients with low rectal cancer, plays a pivotal role in clinical practice. Its primary objective is to completely resect lateral pelvic lymph nodes, block the metastatic pathway of tumor cells, minimize the risk of postoperative recurrence, and provide a foundation for long-term survival. In Japan, LLND has become a standard surgical procedure for low rectal cancer and is widely applied. However, in Europe and North America, neoadjuvant chemoradiotherapy (nCRT) is regarded as the dominant treatment standard, which has led LLND to remain controversial and face doubts in clinical application. This article integrates the latest clinical research findings, explores the trajectory of technical evolution, analyzes clinical efficacy, objectively presents key points of academic controversy, and prospectively considers future developments. It aims to provide a comprehensive professional analysis for the rational application and continuous optimization of this technique in the treatment of low rectal cancer.