Survival Analysis in Rectal Cancer Patients after Lateral Lymph Node Dissection: Exploring the Necessity of nCRT for Suspected Lateral Lymph Node Metastasis

It remains unclear whether combining neoadjuvant chemoradiotherapy (nCRT) with lateral lymph node dissection (LLND) improves survival in patients with rectal cancer suspected of lateral lymph node metastasis (LLNM) compared with LLND alone. A retrospective analysis of clinical data from rectal cancer patients from January 2017 to November 2022 was conducted. Univariate and multivariate Cox regression analyses were performed on patient clinical data, with a focus on identifying potential risk factors that affect disease-free survival (DFS) and overall survival (OS). Patients were divided into nCRT+LLND and LLND groups. K‒M survival curves and log-rank tests were used to analyze the survival outcomes of the different groups. The study included 92 patients. Univariate Cox regression analysis revealed that intraoperative bleeding, pathological LLNM and histological type were associated with DFS. When these factors were included in multivariate Cox regression, pathological LLNM was identified as an independent risk factor for reduced DFS. There were no statistically significant differences between the nCRT+LLND and LLND groups when comparing survival curves for both DFS and OS. In rectal cancer patients with suspected LLNM, TME+LLND without nCRT may be a viable, yet to be validated, therapeutic strategy.