[Ilio-pelvic lymphatic dissection in the rectal cancer]

The method of iliopelvic lymphodissection was used in 61 patients aged from 42 to 72 years having histologically verified rectum cancer. The results of treatment by this method have shown that in 83.6% of the patients the tumor spread corresponded to pT3-T4, the metastatic involvement of regional lymph nodes was found in 52.5% of the patients. The most justified reason for a radical surgery and lymphodissection was a combination of the endoscopic signs of a considerable extension of the tumor around the circumference of the rectum with the CT signs of enlargement of the regional lymph nodes or the ingrowth of the tumor in the pararectal fat. In cases with the lymphogenic metastasing the cumulative 5 year survival was 43.6 +/- 8.7%, in cases without it it was 55.3 +/- 11.8%. A thorough preoperative evaluation of the extension of the tumor process allows to optimize indications for iliopelvic lymphodissection.