J.Jpn. Surg. Soc.. 119(5): 503-508, 2018

---

Feature topic

RECTAL AND ANAL CANCER WITH INGUINAL LYMPH NODE METASTASIS

By histological type of anal canal cancer, adenocarcinoma is the most common in Japan, while squamous cell carcinoma accounts for the majority of cases in Western countries. Inguinal lymph node metastasis of rectal and anal cancer is described separately for adenocarcinoma and squamous cell carcinoma. Many cases with inguinal lymph node metastasis of adenocarcinoma already have other organ metastasis, and surgery leads to a poor prognosis. However, postoperative long-term survival can be achieved in patients with inguinal lymph node metastasis alone. It is recommended that inguinal lymphadenectomy be performed in patients with inguinal lymph node metastasis alone or cases in which other metastatic lesions can be resected simultaneously with the inguinal lymph nodes. Since inguinal lymphadenectomy can lead to many complications and high cancer recurrence rates are seen, it is necessary to establish multidisciplinary treatment combining postoperative chemotherapy and radiotherapy in the future. Even in squamous cell carcinoma, inguinal lymph node metastasis is a poor prognostic factor. Because of the high response rate, chemoradiotherapy is the primary treatment choice. Inguinal lymph node metastasis is confirmed by biopsy, and if no distant metastasis is detected, chemoradiotherapy is performed. Irradiation is administered to the inguinal lymph nodes even if they are negative for metastasis.

---

---

To read the PDF file you will need Adobe Reader installed on your computer.