الفهرس 
Lateral lymph node dissection in rectal cancer : “Does Image Size of Lymph node really matter
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Abstract
The probability of lateral compartment recurrence is significantly increased in rectal cancer diagnosed patients with clinical evidence of LPLN metastases if they get TME without LPLND, even if they undergo combined-modality chemoradiation therapy.
Objectives: The objective of this study is to determine the minimum post neoadjuvant chemoradiotherapy LPLN size that reliably predicts lymph node positivity.
Patients and Methods: This study is a prospective observational cohort study conducted at the National Cancer Institute which included 39 Egyptian with lower rectum cancer patients who were evaluated after meeting the study’s requirements; managed by TME and LPLND in the period from January 2020 till the end of September 2022.
Results: lateral pelvic lymph Node size (post nCRT) ranged between (5-10) mm with median 6.5 mm and mean 7.0 ± 2.2 in negative LPLN group while ranged between (5-12) mm with median 8 mm and mean 8.0 ± 2.1in positive LPLN group with difference of no statistical significance at (p=0.184). To determine whether any of the two research groups has a positive lateral pelvic lymph node, a ROC curve of node size (post nCRT) was built, and the matching areas under curve (AUC) were determined to be 62%, (p=0.184). With sensitivity values of 73.9%, 37.5% and 50%, 8 mm was the ideal cut-off value for Node size (post nCRT) for identifying the lateral pelvic lymph node presence.
Conclusion: Residual lateral pelvic lymph nodes equal or larger than 8 mm after nCRT in lower rectal cancer are highly suspect of being metastasized, and we advise ipsilateral pelvic LN dissection for this group of patients. LPLNs-involved systematic research is required, paying close attention to the anatomical placements, primary- and restaging sizes, and LPLNs themselves.