Preoperative chemoradiation and extended pelvic lymphadenectomy for rectal cancer: Two distinct principles

Table 1 Answers to criticism of extended pelvic lymphadenectomy

Low rate of lateral lymph node metastasis

15.6% for Rba, 12.2% for Rb T3, 25.1% for Rb T4[1]

Poor survival for lateral lymph node positive cases even after dissection

5-year survival of 45.8% in lateral lymph node positive cases[1]

Increased Morbidity

Yes, but decreased by autonomic nerve-preservation[5,6]

Longer operative time and blood loss

Yes

^aRb: Lower rectal cancer below peritoneal reflection.