Prognostic Factors of Rectal Cancer Patients with Lateral Pelvic Lymph Node Metastasis

Background/Aims: We examined the clinicopathological characteristics of rectal cancer patients with lateral pelvic lymph node (LPLN) metastasis in order to clarify their associated prognostic factors. Methodology: A total of 91 rectal cancer patients with LPLN metastasis who underwent curative resection at the National Cancer Center Hospital between 1985 and 2004 were reviewed. Results: The five-year overall survival rate and disease-free survival rate of the studied patients were 39% and 27%, respectively. Univariate analysis showed that tumor differentiation, lymphatic invasion, venous invasion, mesenteric lymph node status and LPLN status were significant prognostic factors. Multivariate analysis showed that tumor differentiation, mesenteric lymph node status and LPLN status were significant prognostic factors. Among 15 patients with LPLN metastasis and without mesenteric lymph node metastasis, 11 patients (73.3%) with one or two LPLN metastases survived more than five years. Among 12 patients with four or more LPLN metastases, two (16.7%) survived more than five years. Conclusions: Tumor differentiation, mesenteric lymph node status and LPLN status are significant prognostic factors of patients with LPLN metastasis. Because some patients with LPLN metastasis survive for a long period, LPLN dissection should be considered for them.