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Updated: Dec 28, 2025

Robot-assisted Total Mesorectal Excision and Lateral Pelvic Lymph Node Dissection for Locally Advanced Middle-low Rectal Cancer

Robot-assisted Total Mesorectal Excision and Lateral Pelvic Lymph Node Dissection for Locally Advanced Middle-low Rectal Cancer

Published on: February 12, 2022

Completion lymph node dissection for merkel cell carcinoma.

John D Cramer¹, Krish Suresh², Shaum Sridharan³

¹Department of Otolaryngology - Head and Neck Surgery, Wayne State University School of Medicine, Detroit, 48220, MI, USA.

American Journal of Surgery

|February 24, 2020

Summary

This summary is machine-generated.

For Merkel cell carcinoma (MCC) with a positive sentinel lymph node biopsy (SLNB), completion lymph node dissection (CLND) alone is linked to worse survival. Adjuvant radiation therapy, with or without CLND, shows better outcomes.

Keywords:

Completion lymph node dissection Merkel cell carcinoma National cancer database Sentinel lymph node biopsy

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Area of Science:

Oncology
Surgical Oncology
Radiation Oncology

Background:

Sentinel lymph node biopsy (SLNB) is standard for Merkel cell carcinoma (MCC).
The role of completion lymph node dissection (CLND) and adjuvant radiation in SLNB-positive MCC remains uncertain.

Purpose of the Study:

To evaluate the impact of CLND and adjuvant radiation on survival in SLNB-positive MCC patients.
To compare outcomes between CLND, observation, and adjuvant radiation strategies.

Main Methods:

Analysis of 447 SLNB-positive MCC patients from the National Cancer Data Base (2012-2015).
Comparison of survival rates for patients undergoing CLND versus observation, with or without adjuvant radiation.

Main Results:

Observation alone was associated with significantly worse overall survival (HR 3.54) compared to CLND with adjuvant radiation.
CLND alone also showed worse overall survival (HR 2.54) than the reference group.
Adjuvant radiation alone (without CLND) did not significantly worsen survival (HR 1.70).

Conclusions:

In SLNB-positive MCC, CLND alone is linked to poorer survival outcomes.
Adjuvant radiation therapy, either with CLND or alone, appears more beneficial than CLND alone or observation.