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01-02-2009

Reduced Lymph Node Yield in Rectal Carcinoma Specimen After Neoadjuvant Radiochemotherapy Has No Prognostic Relevance

Authors: Dietrich Doll, Ralf Gertler, Matthias Maak, Jan Friederichs, Karen Becker, Hans Geinitz, Monika Kriner, Hjalmar Nekarda, Jörg R. Siewert, Robert Rosenberg

Published in: World Journal of Surgery | Issue 2/2009

Abstract

Background

In colorectal surgery UICC/AJCC criteria require a yield of 12 or more locoregional lymph nodes for adequate staging. Neoadjuvant radiochemotherapy for rectal carcinoma reduces the number of lymph nodes in the resection specimen; the prognostic impact of this reduced lymph node yield has not been determined.

Methods

One hundred two patients with uT3 rectal carcinoma who were receiving neoadjuvant radiochemotherapy were compared with 114 patients with uT3 rectal carcinoma who were receiving primary surgery followed by adjuvant radiochemotherapy. Total lymph node yield and number of tumor-positive lymph nodes were determined and correlated with survival.

Results

After neoadjuvant radiochemotherapy both total lymph node yield (12.9 vs. 21.4, p < 0.0001) and number of tumor-positive lymph nodes (1.0 vs. 2.3, p = 0.014) were significantly lower than after primary surgery plus adjuvant radiochemotherapy. Reduced total lymph node yield in neoadjuvantly treated patients had no prognostic impact, with overall survival of patients with 12 or more lymph nodes the same as that of patients with less than 12 lymph nodes. Overall survival of neoadjuvantly treated patients was significantly influenced by the number of tumor-positive lymph nodes with 5-year-survival rates of 88, 63, and 39% for 0, 1–3, and more than 3 positive lymph nodes (p < 0.0001).

Conclusion

The UICC/AJCC criterion of a total lymph node yield of 12 or more should be revised for rectal carcinoma patients.

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Title: Reduced Lymph Node Yield in Rectal Carcinoma Specimen After Neoadjuvant Radiochemotherapy Has No Prognostic Relevance
Authors: Dietrich Doll
Ralf Gertler
Matthias Maak
Jan Friederichs
Karen Becker
Hans Geinitz
Monika Kriner
Hjalmar Nekarda
Jörg R. Siewert
Robert Rosenberg
Publication date: 01-02-2009
Publisher: Springer-Verlag
Published in: World Journal of Surgery / Issue 2/2009
Print ISSN: 0364-2313
Electronic ISSN: 1432-2323
DOI: https://doi.org/10.1007/s00268-008-9838-8

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Reduced Lymph Node Yield in Rectal Carcinoma Specimen After Neoadjuvant Radiochemotherapy Has No Prognostic Relevance

Abstract

Background

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusion

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