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Purpose Inguinal lymph nodes are a rare but recognised site of metastasis in rectal adenocarcinoma. No guideline or consensus exists for the management of such cases. This review aims to provide a contemporary and comprehensive analysis of the published literature to aid clinical decision-making. Methods Systematic searches were performed using the PubMed, Embase, MEDLINE and Scopus and Cochrane CENTRAL Library databases from inception till December 2022. All studies reporting on the presentation, prognosis or management of patients with inguinal lymph node metastases (ILNM) were included. Pooled proportion meta-analyses were completed when possible and descriptive synthesis was utilised for the remaining outcomes. The Joanna Briggs Institute tool for case series was used to assess the risk of bias. Results Nineteen studies were eligible for inclusion, encompassing 18 case series and one population-based study using national registry data. A total of 487 patients were included in the primary studies. The prevalence of ILNM in rectal cancer is 0.36%. ILNM are associated with very low rectal tumours with a mean distance from the anal verge of 1.1 cm (95% CI 0.92–1.27). Invasion of the dentate line was found in 76% of cases (95% CI 59–93). In patients with isolated inguinal lymph node metastases, modern chemoradiotherapy regimens in combination with surgical excision of inguinal nodes are associated with 5-year overall survival rates of 53–78%. Conclusion In specific subsets of patients with ILNM, curative-intent treatment regimens are feasible, with oncological outcomes akin to those demonstrated in locally advanced rectal cancers.

This study aims to understand the factors affecting the switching behaviour of young consumers in the cellular service industry of Pakistan. The present study has identified the significant (price and social influence) and insignificant (network coverage and promotion) factors that provoke consumers to switch their cellular service provider. This research used a quantitative research design, and data were collected using the questionnaire technique. Through random sampling, undergraduate students of private universities of engineering, computer science, and management sciences departments in Karachi, Pakistan, were selected and administered 270 questionnaires. However, 184 respondents provided their useful feedback with a response rate of 68%. The present study has identified that price and social factors play a significant role in influencing consumers switching behaviour. In contrast, promotion and network coverage do not impact young adults switching behaviour in the cellular service sector of Pakistan. Since the research has targeted the telecom industry of Pakistan, it contributes to the literature on marketing and consumer behaviour by identifying and comprehending the theoretical framework and dimensions associated with consumer switching behaviour.