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Prognostic Implications of the Number of Retrieved Lymph Nodes of Patients with Rectal Cancer Treated with Preoperative Chemoradiotherapy

  • Original Article
  • Published:
Journal of Gastrointestinal Surgery

Abstract

Background

The impact of the number of retrieved lymph nodes (LNs) on oncological outcomes in patients with rectal cancer remains unclear. This study was designed to evaluate the prognostic implications of the number of retrieved LNs in patients with rectal cancer receiving preoperative chemoradiotherapy (CRT).

Methods

The study cohort consisted of 859 patients with locally advanced (cT3-4 or cN+) mid to low rectal cancer that had been treated with preoperative CRT and radical resection between 2000 and 2009. Multivariate analysis and the Kaplan-Meier method were used to evaluate the influence of the number of retrieved LNs on disease-free survival (DFS).

Results

The median number of LNs retrieved from included patients was 13 (interquartile range [IQR] 9–17). Multivariate analysis confirmed the independent prognostic importance of the number of retrieved LNs on DFS (hazard ratio = 0.97, 95 % confidence interval = 0.95–0.99, p = 0.029). The 3-year DFS rate in patients with yp stage II rectal cancer was associated with the total number of retrieved LNs.

Conclusions

DFS was associated with the number of LNs retrieved from patients with rectal cancer who received preoperative CRT, especially among patients with ypT3-4 N0 stage tumors. The oncological importance of the number of retrieved LNs should be considered when treating these patients.

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Authors and Affiliations

  1. Department of Colon and Rectal Surgery, Asan Medical Center, University of Ulsan College of Medicine, 86 Asanbyeongwon-gil, Songpa-gu, Seoul, 138-736, South Korea

    In Ja Park, Chang Sik Yu, Seok-Byung Lim, Yong Sik Yoon, Chan Wook Kim & Jin Cheon Kim

  2. Department of Medical Oncology, Asan Medical Center, University of Ulsan College of Medicine, 86 Asanbyeongwon-gil, Songpa-gu, Seoul, 138-736, South Korea

    Tae Won Kim

  3. Department of Radiation Oncology, Asan Medical Center, University of Ulsan College of Medicine, 86 Asanbyeongwon-gil, Songpa-gu, Seoul, 138-736, South Korea

    Jong Hoon Kim

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  1. In Ja Park
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  2. Chang Sik Yu
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  3. Seok-Byung Lim
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Correspondence to In Ja Park.

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Park, I.J., Yu, C.S., Lim, SB. et al. Prognostic Implications of the Number of Retrieved Lymph Nodes of Patients with Rectal Cancer Treated with Preoperative Chemoradiotherapy. J Gastrointest Surg 18, 1845–1851 (2014). https://doi.org/10.1007/s11605-014-2509-1

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  • DOI: https://doi.org/10.1007/s11605-014-2509-1

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