Feasibility and Safety of Lateral Pelvic Lymph Node Dissection After Neoadjuvant Chemoradiotherapy for Elderly Patients With Locally Advanced Rectal Cancer

Abstract

Background/aim: The safety of neoadjuvant chemoradiotherapy (NACRT) combined with total mesorectal excision (TME) and selective lateral pelvic lymph node dissection (LLND) is unclear in elderly patients with locally advanced rectal cancer (LARC).

Patients and methods: Forty-two patients with LARC underwent TME and selective LLND following NACRT at Kobe University Hospital. The clinical outcomes were retrospectively compared between the elderly (aged ≥70 years, n=13) and non-elderly patients (aged <70, n=29).

Results: Twelve of the thirteen elderly patients could complete NACRT. Although the overall rate of postoperative complications did not differ between the groups, abdominal wound infection and deep vein thrombosis developed more frequently in the elderly group. The length of the postoperative hospital stay was similar. Three-year overall survival and 3-year relapse-free survival rates were similar between the groups.

Conclusion: Selective LLND after NACRT is safe for elderly patients with LARC.

Keywords: Elderly; lateral pelvic lymph node dissection; neoadjuvant chemoradiotherapy; rectal cancer.