title: Surgical management of extra-regional lymph node metastasis in colorectal cancer.
abstract: One of the major problems in rectal cancer surgery is local recurrence, found in an average of 21% to 46% cases in 1990. However, the advent of chemo-radiotherapy (CRT) and total mesorectal excision (TME) improve local control and enhances survival rates in colorectal cancer (CRC). Regional lymph node involvement is determined to be an independent prognostic factor in local recurrence; however, extra-regional lymph node (ERLN) metastasis has a higher recurrence rate (up to 58.1%). Lack of supportive data in management of ERLN metastasis in CRC has added further strain and challenges to structure a unique treatment strategy. ERLN refers to extra-mesenteric involvement either in the para-aortic lymph node (PALN) or the lateral pelvic lymph node (LPLN). Treatment of ERLN metastasis is challenging because of the shortage of the resources. Here, we will outline and summarize approaches and management of ERLN metastasis. We also aim to clarify the role of surgical intervention in CRC.
authors.affiliation: a Department of Surgery, College of Medicine , Yonsei University , Seoul , Korea.
authors.forename: Mahdi H
authors.initials: MH
authors.lastname: Albandar
authors.affiliation: a Department of Surgery, College of Medicine , Yonsei University , Seoul , Korea.
authors.forename: Min Soo
authors.initials: MS
authors.lastname: Cho
authors.affiliation: a Department of Surgery, College of Medicine , Yonsei University , Seoul , Korea.
authors.forename: Sung Uk
authors.initials: SU
authors.lastname: Bae
authors.affiliation: a Department of Surgery, College of Medicine , Yonsei University , Seoul , Korea.
authors.forename: Nam Kyu
authors.initials: NK
authors.lastname: Kim
mesh_terms: D015179:Colorectal Neoplasms / Q000473:pathology / Q000601:surgery* / Q000628:therapy; D006801:Humans; D008197:Lymph Node Excision / Q000379:methods*; D008207:Lymphatic Metastasis; D009364:Neoplasm Recurrence, Local; D011379:Prognosis; D015996:Survival Rate
keywords: Extra-regional; colorectal cancer; lymph node; surgical management and metastasis