Researchers sought to ascertain the survival benefits, if any, of adding lateral pelvic lymph node (LPN) dissection (LPND) to total mesorectal excision (TME) in rectal cancer patients with clinical lateral pelvic node metastasis (LPNM).

• Retrospective analysis of a total of 141 rectal cancer patients with clinical evidence of LPNM who underwent TME + LPND; the LPNM group comprised 29 patients and the non-LPNM group had 112 patients.

• Overall LPNM patients have a poor prognosis even after undergoing LPND.

• In addition, there was an independent correlation of LPNM with poor prognosis affecting OS and DFS after TME + LPND.

• However, specific patients with single LPN involvement in the obturator region or internal iliac vessel region appeared to be benefitted in terms of survival in correlation with receiving LPND.

• Furthermore, in stage IV patients, there may be no indication for LPND and their selection should be performed carefully.