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The prognostic impact of the number of lymph nodes retrieved after neoadjuvant chemoradiotherapy with mesorectal excision for rectal cancer

Authors
 YOUNG-WAN KIM  ;  NAM-KYU KIM  ;  BYUNG-SOH MIN  ;  KANG-YOUNG LEE  ;  SEUNG-KOOK SOHN  ;  CHANG-HWAN CHO  ;  HOGUEN KIM  ;  KI-CHANG KEUM  ;  JUNG-BAI AHN 
Citation
 JOURNAL OF SURGICAL ONCOLOGY, Vol.100(1) : 1-7, 2009 
Journal Title
 JOURNAL OF SURGICAL ONCOLOGY 
ISSN
 0022-4790 
Issue Date
2009
MeSH
Adult ; Aged ; Combined Modality Therapy ; Female ; Humans ; Lymph Node Excision* ; Male ; Middle Aged ; Prognosis ; Rectal Neoplasms/mortality ; Rectal Neoplasms/pathology ; Rectal Neoplasms/surgery* ; Survival Rate
Keywords
rectal neoplasm ; retrieved lymph node ; neoadjuvant chemoradiation ; mesorectal excision
Abstract
BACKGROUND: We aimed to assess factors associated with the number of nodes retrieved and the impact of the number of lymph nodes in rectal cancer patients who underwent neoadjuvant chemoradiation with radical surgery. METHODS: A total of 258 patients were enrolled. Lymph nodes were retrieved from specimens using a manual dissection technique. RESULTS: Of the 258 patients, nine patients had an absence of lymph nodes (ypNx), 150 patients had a node-negative status (ypN(-)) and 99 patients had node-positive disease (ypN(+)). An advanced ypT classification (ypT3,4) and larger tumor (>4 cm) were associated with an increased number of nodes retrieved. The pretreatment CEA level (>5 ng/ml) and ypN(+) classification were significant risk factors for cancer specific and recurrence free survival. There was no significant difference of oncological outcomes among ypNx patients and a subset of ypN(-) patients based on the number of nodes retrieved using three cutoff values (1-11, 12-25, and 25-65 nodes). CONCLUSIONS: In a neoadjuvant setting, ypN(+) disease was an independent risk factor for oncological outcomes. An absence of nodes does not represent an inferior oncological outcome. The number of nodes does not seen to impact survival and recurrence in ypN(-) patients.
Full Text
http://onlinelibrary.wiley.com/doi/10.1002/jso.21299/abstract
DOI
10.1002/jso.21299
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Surgery (외과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Pathology (병리학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Radiation Oncology (방사선종양학교실) > 1. Journal Papers
Yonsei Authors
Keum, Ki Chang(금기창) ORCID logo https://orcid.org/0000-0003-4123-7998
Kim, Nam Kyu(김남규) ORCID logo https://orcid.org/0000-0003-0639-5632
Kim, Ho Keun(김호근)
Min, Byung Soh(민병소) ORCID logo https://orcid.org/0000-0003-0180-8565
Sohn, Seung Kook(손승국)
Ahn, Joong Bae(안중배) ORCID logo https://orcid.org/0000-0001-6787-1503
Lee, Kang Young(이강영)
Cho, Chang Hwan(조장환)
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/104590
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