Related Experiment Video
Updated: May 16, 2025
Robot-assisted Total Mesorectal Excision and Lateral Pelvic Lymph Node Dissection for Locally Advanced Middle-low Rectal Cancer
Published on: February 12, 2022
Diagnostic accuracy of lateral lymph node metastasis for locally advanced rectal cancer after neoadjuvant therapy: a
Kosuke Ozaki1, Kazushige Kawai2, Shimpei Ogawa3
1Department of Gastroenterological Surgery, Cancer Institute Hospital of the Japanese Foundation for Cancer Research, Tokyo, Japan.
Background:
The optimal criteria for lateral lymph node dissection (LLND) in rectal cancer following neoadjuvant therapy remain undefined. This systematic review and meta-analysis evaluated the diagnostic accuracy of lateral lymph node metastasis (LLNM) to refine criteria for selective LLND.
Research Design And Methods:
A systematic search of PubMed, Embase, and the Cochrane Library (10 August 2024) identified studies assessing magnetic resonance imaging (MRI)-based LLNM detection in patients with rectal cancer who underwent neoadjuvant therapy and radical surgery. Studies reporting MRI-based LLNM assessments with pathological confirmation were included. Non-English studies, reviews, case reports, and those lacking lymph node size data were excluded. The risk of bias was assessed using QUADAS-2. Pooled sensitivity, specificity, and diagnostic odds ratios were estimated using hierarchical summary receiver operating characteristic curve (HSROC) analysis.
Results:
Eleven studies met the inclusion criteria. All used MRI-based size assessments. The pooled sensitivity and specificity were 0.776 (95% CI: 0.639-0.872) and 0.694 (95% CI: 0.541-0.813), respectively, with an HSROC area under the curve (AUC) of 0.801.
Conclusions:
MRI is the most widely used modality for diagnosing LLNM in rectal cancer patients who have undergone neoadjuvant therapy, with size criteria being the most commonly applied.
Registration:
PROSPERO (CRD42024578499).
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