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Prognostic Value of Sterilized Lymph Nodes After Preoperative Chemoradiotherapy for Patients with ypN0 Rectal Cancer

  • Colorectal Cancer
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Background

Patients with ypN0 rectal cancer who have received preoperative chemoradiotherapy can be divided into those who initially were node negative and those whose positive nodes have been sterilized by preoperative therapy. The long-term prognosis for ypN0 patients with sterilized lymph nodes (LNS) is unknown. This study aimed to assess the prognostic value of LNS after preoperative chemoradiotherapy for patients with ypN0 rectal cancer.

Methods

From January 2007 to March 2014, 206 patients with ypN0 tumors of the mid or lower rectum treated by chemoradiotherapy and radical surgery were enrolled in the study. Of these 206 patients, 49 had ypN0 tumors with LNS (LNS+ group), and 157 had ypN0 tumors without LNS (LNS− group). The patients in both groups were comparable in terms of tumor characteristics, type of chemoradiotherapy, type of surgery, R0 resection rate, and postoperative complication rate.

Results

The mean follow-up period was 40.5 ± 27 months. The 1- and 3-year OS rates in the LNS+ group were respectively 100 and 95.5% versus 99.4 and 91.6% in the LNS− group (P = 0.549). The 1- and 3-year DFS rates in the LNS+ group were respectively 100 and 94.2% versus 94.7 and 87.1% in the LNS− group (P = 0.117). The multivariate analysis showed that the presence of LNS did not affect OS (P = 0.918) or DFS (P = 0.209).

Conclusions

The prognosis is excellent for patients with ypN0 rectal cancer who have LNS after preoperative chemoradiotherapy. The presence of LNS in ypN0 rectal cancer patients after chemoradiotherapy should not be considered a factor for a poor prognosis.

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Disclosures

Valérie Boige is a consultant for Bayer, Prestizia, and Merck Serono, and has served as expert testimony for Bayer, Merck Serono, Sanofi, Novartis, Roche, and Daiichi Sankyo. Diane Goéré receives speaker fees from Sanofi, Novartis, and Roche. Antoine Brouquet receives speaker fees from Takeda, Merck Serono, and Roche. Christophe Penna receives speaker fees from Merck Serono, Roche, and Takeda, and serves as expert testimony for Merck Serono. Stéphane Benoist receives speaker fees from Roche, Amgen, Merck Serono, Nestlé, Takeda, and Abbvie and serves as expert testimony for Roche, Merck Serono, Sanofi, Takeda, and Amgen. Karina Vychnevskaia, Frederic Dumont, Julie Agostini, Catherine Julié, Peggy Dartigues, Thierry Lazure, and Frédérique Peschaud had no conflict of interest.

Funding

No funding was received in support of this work.

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Authors and Affiliations

  1. Department of Digestive and Oncologic Surgery, Ambroise Paré Hospital, APHP, UVSQ University, Boulogne, France

    Karina Vychnevskaia MD & Frédérique Peschaud MD, PhD

  2. General Surgical Oncology Department, Gustave Roussy, Villejuif, France

    Frederic Dumont MD & Diane Goéré MD, PhD

  3. Department of Digestive Surgery and Surgical Oncology, Bicêtre Hospital, Assistance Publique Hôpitaux de Paris, Université Paris–Sud, Le Kremlin Bicêtre, France

    Julie Agostini MD, Antoine Brouquet MD, PhD, Christophe Penna MD & Stéphane Benoist MD, PhD

  4. Department of Pathology, Ambroise Paré Hospital, APHP, UVSQ University, Boulogne, France

    Catherine Julié MD

  5. Department of Pathology, Gustave Roussy, Villejuif, France

    Peggy Dartigues MD

  6. Department of Pathology, Bicêtre Hospital, APHP, Paris–Sud, University, Le Kremlin Bicêtre, France

    Thierry Lazure MD

  7. Department of Oncologic Medicine, Gustave Roussy, Villejuif, France

    Valérie Boige MD, PhD

Authors
  1. Karina Vychnevskaia MD
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  2. Frederic Dumont MD
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  4. Catherine Julié MD
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  8. Diane Goéré MD, PhD
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  9. Antoine Brouquet MD, PhD
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  12. Stéphane Benoist MD, PhD
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Corresponding author

Correspondence to Stéphane Benoist MD, PhD.

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Vychnevskaia, K., Dumont, F., Agostini, J. et al. Prognostic Value of Sterilized Lymph Nodes After Preoperative Chemoradiotherapy for Patients with ypN0 Rectal Cancer. Ann Surg Oncol 24, 1304–1311 (2017). https://doi.org/10.1245/s10434-016-5736-8

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  • DOI: https://doi.org/10.1245/s10434-016-5736-8

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