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Depth of Tumor Invasion Independently Predicts Lymph Node Metastasis in T2 Rectal Cancer

  • Original Article
  • Published:
Journal of Gastrointestinal Surgery

Abstract

Objective

The aim of this study was to identify risk factors of lymph node metastasis (LNM) for T2 rectal cancer.

Methods

From a prospectively maintained single-institution database, we identified 346 consecutive pT2 rectal cancers treated with total mesorectal excision from 1998 to 2009. Univariate and multivariate analyses were performed to identify risk factors associated with overall and intermediate/apical LNM. The incidence of overall and intermediate/apical LNM was analyzed by tree analysis.

Results

Age, tumor location, pathological features, and depth of invasion were independent predictors for overall LNM. Tumor location, pathological features, and depth of invasion were independent predictors for intermediate/apical LNM. Tree analysis showed that the incidence of LNM was 7.7% for upper rectal cancer with favorable pathological features, and 3.4% for mid/lower rectal cancer without other identified risk factors. The incidence of intermediate/apical LNM was 5.7% for superficial T2 rectal cancer with favorable pathological features, and 3.1% for deep T2 rectal cancer locating in upper rectum with favorable pathological features.

Conclusions

Depth of invasion is an independent predictor for LNM in T2 rectal cancer. Using tree analysis, we identified a subset of patients with low risk of LNM who may be candidates of local excision.

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Authors and Affiliations

  1. State Key Laboratory of Oncology in South China, Guangzhou, Guangdong, 510060, People’s Republic of China

    Pei-Rong Ding, Xin An, Yun Cao, Xiao-Jun Wu, Li-Ren Li, Gong Chen, Zhen-Hai Lu, Yu-Jing Fang, De-Sen Wan & Zhi-Zhong Pan

  2. Department of Colorectal Surgery, Cancer Center, Sun Yat-sen University, Guangzhou, Guangdong, 510060, People’s Republic of China

    Pei-Rong Ding, Xiao-Jun Wu, Li-Ren Li, Gong Chen, Zhen-Hai Lu, Yu-Jing Fang, De-Sen Wan & Zhi-Zhong Pan

  3. Department of Medical Oncology, Cancer Center, Sun Yat-sen University, Guangzhou, Guangdong, 510060, People’s Republic of China

    Xin An

  4. Department of Pathology, Cancer Center, Sun Yat-sen University, Guangzhou, Guangdong, 510060, People’s Republic of China

    Yun Cao

  5. 651 Dongfeng Road East, Guangzhou, China, 510060

    De-Sen Wan & Zhi-Zhong Pan

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  1. Pei-Rong Ding
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  2. Xin An
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Correspondence to Pei-Rong Ding.

Additional information

This study was jointly supported by the Science and Technology Planning Project of Guangdong Province (grant No. 2008B030301119) and Medical Scientific Research Foundation of Guangdong Province (grant No. B2008057)

Pei-Rong Ding, Xin An, and Yun Cao contributed equally to this work

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Ding, PR., An, X., Cao, Y. et al. Depth of Tumor Invasion Independently Predicts Lymph Node Metastasis in T2 Rectal Cancer. J Gastrointest Surg 15, 130–136 (2011). https://doi.org/10.1007/s11605-010-1353-1

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  • DOI: https://doi.org/10.1007/s11605-010-1353-1

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