Abstract: Lateral pelvic lymph node(LPLN)is a common local site of metastasis in patients with low rectal cancer,and it is also the main site of postoperative local recurrence.However,there is still no clear conclusion about the treatment plan for LPLN metastasis.At the same time,the metastasis of LPLN should be regarded as local diseases rather than systemic.Neoadjuvant radiotherapy and chemotherapy(CRT)cannot replace surgical dissection.Lateral lymph node dissection(LLND)is still indispensable.However,since LLND may mean longer operative time and more postoperative complications,it may be over-treatment for all patients with low rectal cancer,so it is particularly important to select patients who can benefit.The size of the LPLN,the reduction ratio of the short path,the signal strength,and the edge characteristics should all be considered in the screening.

Key words: Low rectal cancer, Lateral lymph node dissection, Neoadjuvant therapy, Imaging