Short-term preoperative radiotherapy in rectal cancer patients leads to a reduction of the detectable number of lymph nodes in resection specimens

Maschuw, Katja; Kress, Ralf; Ramaswamy, Annette; Braun, Isabell; Langer, Peter; Gerdes, Berthold

doi:10.1007/s00423-006-0056-2

Cited by 18 publications

(11 citation statements)

References 17 publications

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“…Thorn found a higher number of lymph nodes in the mid rectal tumours [34]. Other significant positive association was found with involvement of the anterior quadrant, intravascular and perineural invasion, positive high tie lymph node, high Duke's and pT stages and poor response to neoadjuvent CRT as defined by Mandar, these finding are in agreement with some studies [12,20] but not with others [34,35]. Other histological features as the percentage of tumour load and tumour necrosis had a positive effect of the lymph node number while tumour fibrosis has a significant negative impact.…”

Section: Discussionsupporting

confidence: 82%

Factors Influence Lymph Node Retrieval after Resection for Rectal Cancer

Elsheikh¹,

M²

2016

J Adenocarcinoma

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Introduction: Total lymph node (TLN) count is an important qualifier of cancer evaluation and extensive nodal resection has been associated with lower rates of cancer recurrence; allows for more accurate cancer staging and improved survival following resection for rectal cancer. Aim:To examine the adequacy of lymph node sampling in rectal cancer and the influence of the clinicopathological factors and treatment modalities on the total lymph node yield.Methods: This is a retrospective study includes 409 cases of rectal cancer treated by surgical intervention only (126 cases), or surgery after short or long course chemotherapy (75 and 208 cases respectively).Results: TLN count range from (2-50, mean 12.38). Twelve lymph nodes were found in 49.4% of the specimens with or without neoadjuvent chemo radiatherapy (CRT). Patient treated with surgery only have a significant high total LN yield (mean is 15.53) in comparison with (12.99 and 10.25 for short course CRT and long course CRT respectively, P value <0.001). The number of lymph nodes was significantly correlated with the modality of treatment, anterior quadrant involvement, vascular and perineural invasion, pathological staging, Duke's and Mandard staging. On multivariate only perineural invasion, high tie lymph node involvement, Dukes stage, and tumour load were found to be the main predictors of the number of lymph node yield. Conclusion:The neoadjuvent CRT has a significant effect on the adequacy of lymph node sampling and a negative impact on the lymph nodes retrieved. This negative effect was more prominent with the long term rather than the short term CRT. This should be taken in consideration at the N staging of the tumour to avoid down-staging.

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Section: Discussionsupporting

confidence: 82%

Factors Influence Lymph Node Retrieval after Resection for Rectal Cancer

Elsheikh¹,

M²

2016

J Adenocarcinoma

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“…This is in accordance with the fact that right-sided resections have, generally, a potential for a larger number of retrieved nodes [13][14][15]. Despite this, the well-accepted gold-standard number of 12 nodes do not relate to tumor location.…”

Section: Discussionsupporting

confidence: 78%

“…Additionally, neoadjuvant chemoradiotherapy in patients with rectal cancer is associated, as well, with a low number of detectable lymph nodes [14]. In our study, this factor did not play a major role as only three patients underwent neoadjuvant chemoradiotherapy and they were equally divided between the two groups.…”

Section: Discussionmentioning

confidence: 78%

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Number of retrieved lymph nodes and survival in node-negative patients undergoing laparoscopic colorectal surgery for cancer

et al. 2010

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“…However, no association was found between the number of lymph nodes examined in pN0 patients and overall or disease-free survival [ 28• ]. Others have reported similar fi ndings of decreased lymph node numbers associated with long-course preoperative chemoradiation therapy [ 29 ] and following short-course preoperative radiotherapy [ 30 ].…”

Section: Lymph Node Retrieval After Preoperative Crt For Locally Advasupporting

confidence: 65%