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See Latest ArticlesExtended lymphadenectomy versus conventional surgery for rectal cancer: a meta-analysis : The Lancet Oncology
The Lancet Oncology - Online First, 10/23/09
Georgiou P et al. – Extended lymphadenectomy does not seem to confer a significant overall cancer-specific advantage, but does seem to be associated with increased urinary and sexual dysfunction.
Methods- Searched Medline, Embase, Ovid, Cochrane Library, and Google Scholar for studies published between 1965 and 2009 that compared extended lymphadenectomy (EL) with standard rectal resection
- 20 studies, which included 5502 patients from 1 randomised, 3 prospective non-randomised, and 14 retrospective case—control studies published between 1984 and 2009, met our search criteria and were assessed
- 2577 patients underwent EL and 2925 underwent non-EL for rectal cancer
- Random and fixed-effects meta-analytical models were used where indicated, and between-study heterogeneity was assessed
- End-points evaluated included peri-operative outcomes, 5-year survival and recurrence rates
- Operating time significantly longer in EL group by 76·7 min
- Intra-operative blood loss greater in EL group by 536·5 mL
- Peri-operative mortality and morbidity similar between two groups
- Data from individual studies showed male sexual dysfunction and urinary dysfunction were more prevalent in EL group
- No significant differences in 5-year survival (hazard ratio [HR] 1·09, 95% CI 0·78—1·50), 5-year disease-free survival (HR 1·23, 95% CI 0·75—2·03 ), and local (OR 0·83, 95% CI 0·61—1·13) or distant recurrence (OR 0·93, 95% CI 0·72—1·21)
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