Do you ever utilize short-course radiation when lateral pelvic (extra-mesorectal) lymph nodes are involved?

My general preference is to use long course chemoradiation for patients with involved extramesorectal/lateral lymph nodes as it is a relatively strong risk factor for pelvic recurrence and such lymph nodes are not routinely surgically resected. While the pre-TNT era randomized trials comparing short...

We have a manuscript (Hassanzadeh C et al., DCR 2023, in press), addressing this exact question. In brief, we evaluated 121 patients that received SCRT and consolidative chemotherapy. 38 patients (26%) had lateral pelvic lymphadenopathy. As expected, those with LPLN+ had worse PFS. SCRT plus SIB to ...

Lateral pelvic LNs are encountered at an increasing frequency with the widespread use of MR imaging in rectal cancer staging. Local therapy of these LNs is challenging, as they are often located outside the normal TME resection volume. Resection of these lymph nodes is associated with a higher risk ...

Yes