Chemoradiotherapy Sequenced Radical Surgery for Colorectal Cancer With PALNM

Concurrent Chemoradiotherapy Sequenced Radical Surgery for Para-aortic Lymph Node Metastasis of Left-sided Colon and Rectal Cancer

In left-sided colon and rectal cancer, the occurrence of synchronous para-aortic lymph node metastasis is rare, with the incidence of being approximate 1-2%. Currently, there has been no standard treatment strategy for this situation. The present trial is designed to evaluate the safety and efficacy of para-aortic lymph node dissection for left-sided colon and rectal cancer with synchronous para-aortic lymph node metastasis

Inclusion Criteria:

• age at enrollment is ≥ 18 and ≤ 75 years
• ECOG PS 0-1
• histologically confirmed left-sided colon and rectal carcinoma
• synchronous para-aortic lymph node metastases confirmed by PET-CT, and located below the level of renal veins and above the bifurcation of iliac artery
• patients potential to receive surgery and achieve no evidence of disease (NED)
• able to tolerate surgery
• providing written informed consent

Exclusion Criteria:

• local invasion or distant metastasis other than para-aoritc lymph nodes
• history of other malignant tumor
• coupled with severe systematic diseases (recent myocardial infarction, cardiomyopathy, or acute pulmonary infection)
• emergency surgery