Yonsei Med J.  2013 Mar;54(2):389-395. 10.3349/ymj.2013.54.2.389.

Contributing Factors on Lymph Node Yield after Surgery for Mid-Low Rectal Cancer

• Ahn YJ
• Kwon HY
• Park YA
• Sohn SK
• Lee KY

• KMID: 1503901
• DOI: http://doi.org/10.3349/ymj.2013.54.2.389

Abstract

PURPOSE
The purpose of the present study was to evaluate the contributing factors to the lymph node status as well as to define the impact of preoperative concurrent chemoradiotherapy (CCRT) on the number of lymph nodes retrieved in mid-low rectal cancer.
MATERIALS AND METHODS
We retrospectively analyzed 277 patients who underwent curative surgical resection for mid-low rectal cancer between 1998 and 2007. Eighty-two patients received long course preoperative CCRT followed by surgery.
RESULTS
A mean of 13.12+/-9.28 lymph nodes was retrieved. In a univariate analysis, distance from the anal verge, pT stage, pN stage, lymphovascular invasion, preoperative CCRT had significant influence on the number of lymph nodes retrieved. In a multivariate model, patients in the CCRT group had fewer retrieved lymph nodes than the non-CCRT group (p<0.001). Both univariate and multivariate analyses showed that the ypN0 group had fewer retrieved lymph nodes than the ypN1-2 group (p=0.027) in the CCRT group.
CONCLUSION
Preoperative CCRT was an independent risk factor for failure to harvest an appropriate number of lymph nodes, and node-negative patients who received CCRT had fewer lymph nodes harvested.

Keyword

Rectal neoplasm; lymph node; neoadjuvant therapy

MeSH Terms

Adult
Aged
Aged, 80 and over
Chemoradiotherapy/*methods
Female
Humans
*Lymph Node Excision
Lymph Nodes/pathology/*surgery
Lymphatic Metastasis/pathology
Male
Middle Aged
Multivariate Analysis
Neoplasm Staging
Preoperative Period
Prognosis
Rectal Neoplasms/pathology/*surgery
Retrospective Studies
Risk Factors

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