Title: Predictors and histological effects of preoperative chemoradiotherapy for rectal cancer
and control of lateral lymph node metastasis
Version: 1 Date: 26 May 2022
Reviewer:  Alexis Ulrich
Reviewer's report:
The authors present their data on 168 patients with low rectal cancer less than 7 cm from the av
receiving nCRT and TME without LLND between 2009 and 2016.
In Western countries LLND is rarely performed as only 3% develop LLN metastases and the
need for LLND is not clear. The authors try to find predictors for LLN involvement and could
show that in their small cohort the pre nCRT (>11.6mm) and post CRT (>5.5mm) size of the
LLN were predictive. Furthermore, the PLR before and after CRT seemed to predict lateral
positive notes. The authors point to the limitations of the study.
The manuscript is well written, though the conclusions are a little weak. Do the authors suggest
to perform LLND in case of increased risk according to size and PLR? Would it really decrease
local recurrence? Does increased morbidity due to LLND justify the extension of the operation?
In case of larger Lymph nodes at only one side, would the authors recommend LLND only of
the involved or both sides? Please discuss.
Title: Predictors and histological effects of preoperative chemoradiotherapy for rectal cancer
and control of lateral lymph node metastasis
Version: 1 Date: 26 May 2022
Reviewer:  Alexis Ulrich
Reviewer's report:
The authors present their data on 168 patients with low rectal cancer less than 7 cm from the av
receiving nCRT and TME without LLND between 2009 and 2016.
In Western countries LLND is rarely performed as only 3% develop LLN metastases and the
need for LLND is not clear. The authors try to find predictors for LLN involvement and could
show that in their small cohort the pre nCRT (>11.6mm) and post CRT (>5.5mm) size of the
LLN were predictive. Furthermore, the PLR before and after CRT seemed to predict lateral
positive notes. The authors point to the limitations of the study.
The manuscript is well written, though the conclusions are a little weak. Do the authors suggest
to perform LLND in case of increased risk according to size and PLR? Would it really decrease
local recurrence? Does increased morbidity due to LLND justify the extension of the operation?
In case of larger Lymph nodes at only one side, would the authors recommend LLND only of
the involved or both sides? Please discuss.
Please review this paper.
user
Title: Predictors and histological effects of preoperative chemoradiotherapy for rectal cancer
and control of lateral lymph node metastasis
Version: 1 Date: 26 May 2022
Reviewer:  Alexis Ulrich
Reviewer's report:
The authors present their data on 168 patients with low rectal cancer less than 7 cm from the av
receiving nCRT and TME without LLND between 2009 and 2016.
In Western countries LLND is rarely performed as only 3% develop LLN metastases and the
need for LLND is not clear. The authors try to find predictors for LLN involvement and could
show that in their small cohort the pre nCRT (>11.6mm) and post CRT (>5.5mm) size of the
LLN were predictive. Furthermore, the PLR before and after CRT seemed to predict lateral
positive notes. The authors point to the limitations of the study.
The manuscript is well written, though the conclusions are a little weak. Do the authors suggest
to perform LLND in case of increased risk according to size and PLR? Would it really decrease
local recurrence? Does increased morbidity due to LLND justify the extension of the operation?
In case of larger Lymph nodes at only one side, would the authors recommend LLND only of
the involved or both sides? Please discuss.
assistant