J Korean Surg Soc.  2013 Jul;85(1):30-34.

Clinical impact of fat clearing technique in nodal staging of rectal cancer after preoperative chemoradiotherapy

• Kim IK
• Lim BJ
• Kang J
• Kim SA
• Kang D
• Sohn SK
• Lee KY

Abstract

PURPOSE
This study was designed to evaluate the efficacy of a fat clearing technique for accurate nodal staging of rectal cancer patients after preoperative chemoradiotherapy (CRT).
METHODS
A total of 19 patients with rectal cancer within 10 cm from anal verge were divided into two groups: non-CRT group (n = 10) and CRT group (n = 9). For pathologic assessment, lymph node (LN) harvest was performed using conventional manual dissection followed by a fat clearing technique.
RESULTS
A median of 3.0 additional LNs in non-CRT group and 3.8 LNs in CRT group were identified by the fat clearing technique. When subanalysis was performed in patients with fewer than 12 retrieved LNs, a median of 4.0 extra LNs in non-CRT group and 3.5 extra LNs in CRT group were identified after the fat clearing technique. None of additionally identified nodes were metastatic. In both groups, the median size of retrieved LNs following the fat clearing technique was smaller than that obtained by manual dissection (2.0 mm vs. 3.0 mm, P < 0.001).
CONCLUSION
The fat clearing technique allowed detection of additional LNs that were missed by the manual method, but these detected LNs were not proven to be metastatic.

Keyword

Fat clearing technique; Preoperative chemoradiotherapy; Rectal neoplasms

MeSH Terms

Chemoradiotherapy
Humans
Lymph Nodes
Rectal Neoplasms

Figure

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  Fig. 1 Median size of retrieved lymph nodes with or without fat clearing technique in (A) non-CRT group, and in (B) CRT group. CRT, chemoradiotherapy.

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