Authors
Treerat Tangpulphon, Akira Ouchi, Nattapanee Sukphol, Tanyawan Heingraj, Kitrawee Jirathaniruangkit, Takashi Kinoshita, Yusuke Sato, Takayoshi Kishida, Songphol Malakorn, Koji Komori, Tetsuya Abe
Published in
Surgery today. Aug 21, 2026. Epub Aug 21, 2026.
Abstract
To evaluate the oncologic outcomes and prognostic factors after salvage lateral lymph node resection for isolated lateral lymph node recurrence (LLNR).
Rectal cancer patients with isolated LLNR who underwent salvage surgery at tertiary centers in Japan and Thailand between January 2013 and December 2024 were included. The primary endpoints were overall survival (OS), recurrence-free survival (RFS), and local re-recurrence.
Thirty patients were included, with a median follow-up of 47.5 months. Salvage procedures included tumor resection in 19 patients (63.3%), tumor resection with adjacent organ resection in 5 (16.7%), and total pelvic exenteration in 6 (20.0%). After salvage surgery, 21 patients (70.0%) developed re-recurrence, and 11 (36.7%) had local re-recurrence. The five-year OS was 73.8%, 5-year RFS was 22.3%, and 5-year cumulative incidence of local re-recurrence was 61.7%. A multivariate analysis revealed that extensive salvage operations, including tumor resection with adjacent organ resection and total pelvic exenteration, were strongly associated with local re-recurrence (HR 8.43, p = 0.014). An LLN size ≥ 17 mm tended to increase the risk of local re-recurrence (HR 3.52, p = 0.071).
Salvage resection for isolated LLNR provides an acceptable OS, but re-recurrence remains frequent. Careful patient selection using PET-CT and multidisciplinary discussions are essential, particularly for patients who require extensive surgery.
PMID:
42627503
Bibliographic data and abstract were imported from PubMed on 22 Aug 2026.
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