Ogura A, et al. - Researchers conducted this multicenter pooled cohort study with 741 low rectal cancer patients following chemoradiotherapy or radiotherapy to determine the role of restaging magnetic resonance imaging (MRI) in these patients. In addition, they sought to present specific guidelines on which patients might benefit from a lateral lymph node dissection (LLND). They noted that the risk of lateral local recurrence (LLR) disappeared after a decrease of lateral nodes from a short-axis node size of 7 mm or greater on primary MRI to a short-axis node size of 4 mm or less on restaging MRI. However, restaging MRI indicating persistently enlarged nodes (greater than 4 mm) in the internal iliac compartment was identified to be correlated with a high risk of LLR, and this risk was significantly reduced with an LLND. These findings highlight the significance of restaging MRI in clinical decision making in lateral nodal disease.