Abstract
Optimal management for isolated para-aortic lymph node (PALN) recurrence from colorectal cancer (CRC) remains undefined. We evaluated the efficacy and safety of radiotherapy (RT) for this indication. A PRISMA-compliant systematic review and meta-analysis (PROSPERO CRD42025634494) was conducted using four databases through April 2025. Pooled locoregional progression-free survival (LPFS), progression-free survival (PFS), and overall survival (OS) were estimated using a random-effects model. Five retrospective studies (n = 220) were included. Pooled 1- and 3-year LPFS were 84% (95% CI, 78–89%) and 69% (62–76%), respectively. Pooled 1- and 3-year PFS were 54% (42–65%) and 22% (14–32%). Pooled 1- and 3-year OS were 91% (87–95%) and 64% (54–73%). Primary colon tumors were associated with poorer survival outcomes, while female sex predicted improved 3-year PFS. Severe (grade ≥ 3) acute and chronic toxicities were low (7.7% and 0.5%, respectively). Modern RT for PALN recurrence from CRC provides favorable local control with acceptable toxicity. With a 3-year OS of 64%, RT offers a potential survival benefit for carefully selected patients.
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Data availability
All data analyzed during this study were extracted from previously published articles and are publicly available in the cited references. No individual patient data were generated. The compiled dataset used for analysis is available from the corresponding author upon reasonable request.
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Funding
This work was supported by the Dongguk University, College of Medicine Research Fund of 2025. Additionally, this research was supported by the Korea Institute of Radiological & Medical Sciences (KIRAMS, Seoul, Korea) (No. 50552 − 2025).
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Conceptualization and design: Mi-Sook KimData acquisition: Seok-Joo Chun, Hyunkyung KimMethodology: Seok-Joo Chun, Jiyun Jung, Sun Hyun BaeAnalysis and interpretation: Seok-Joo Chun, Jiyun Jung, Sun Hyun Bae, Mi-Sook KimWriting and editing: Seok-Joo Chun, Sun Hyun Bae, Mi-Sook KimResources and support: Seok-Joo ChunProject administration: Sun Hyun Bae, Mi-Sook KimSupervision: Sun Hyun Bae, Mi-Sook Kim.
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Chun, SJ., Kim, H., Jung, J. et al. Isolated para-aortic lymph node recurrence from colorectal cancer treated by radiotherapy: a systematic review and meta-analysis. Sci Rep (2026). https://doi.org/10.1038/s41598-026-41478-3
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DOI: https://doi.org/10.1038/s41598-026-41478-3
