In a patient with rectal adenocarcinoma and involved gluteal lymph nodes, what would your elective lymph node volume include?  

I think the most important issue to address in this case, is how disease accessed the subgluteal space. I had a case like this in a patient with a very deeply invasive disease. During chemoRT, the patient required a diverting ileostomy after they developed a recto-cutaneous fistula due to rapid tumo...