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The impact of lymph node size to predict nodal metastasis in patients with rectal cancer after preoperative chemoradiotherapy

 Im-kyung Kim  ;  Jeonghyun Kang  ;  Beom Jin Lim  ;  Seung-Kook Sohn  ;  Kang Young Lee 
 International Journal of Colorectal Disease, Vol.30(4) : 459-464, 2015 
Journal Title
 International Journal of Colorectal Disease 
Issue Date
Aged ; Chemoradiotherapy, Adjuvant* ; Female ; Humans ; Lymph Nodes/pathology* ; Lymphatic Metastasis ; Male ; Middle Aged ; Neoplasm Staging ; Preoperative Care ; ROC Curve ; Rectal Neoplasms/pathology* ; Rectal Neoplasms/surgery ; Rectal Neoplasms/therapy*
Rectal cancer ; Preoperative chemoradiotherapy ; Lymph node size
PURPOSE: During restaging after preoperative chemoradiotherapy (CRT), the assessment of lymph node (LN) metastasis is vital for selecting further treatment strategies. This study aimed to evaluate the impact of LN size to predict LN metastasis in rectal cancer patients after preoperative CRT. METHODS: A total of 30 consecutive patients who underwent preoperative CRT followed by curative resection of primary rectal cancer were selected as a study group (CRT group). As a control group (non-CRT group), 30 patients who underwent primary tumor resection were selected using a 1:1 case-match design. Matching criteria were gender, age, and clinical T stage. The size of each LN was measured from the surgical specimen. To clarify optimal cutoff values for node size according to the risk of detecting metastasis, receiving-operator characteristic (ROC) curves were generated. RESULTS: In the non-CRT group, 39/474 LNs were confirmed to have metastasis. In the CRT group, 29/422 LNs showed metastasis. The median size of metastatic LNs was 6.0 mm in CRT group, which was significantly larger than 4.0 mm in the non-CRT group (p = 0.006). The optimal cutoff value for determining metastasis in the CRT group was 4.5 mm, compared to 3.5 mm in the non-CRT group. The accuracy of the cutoff value was much higher in the CRT group (CRT vs. non-CRT, 77.9 vs. 59.9%). CONCLUSIONS: LN size is a strong indicator for prediction of regional LN metastasis in rectal cancer patients after preoperative CRT, compared to those without CRT.
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1. College of Medicine (의과대학) > Dept. of Surgery (외과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Pathology (병리학교실) > 1. Journal Papers
Yonsei Authors
Kang, Jeonghyun(강정현) ORCID logo https://orcid.org/0000-0001-7311-6053
Kim, Im Kyung(김임경) ORCID logo https://orcid.org/0000-0001-8505-5307
Sohn, Seung Kook(손승국)
Lee, Kang Young(이강영)
Lim, Beom Jin(임범진) ORCID logo https://orcid.org/0000-0003-2856-0133
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