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01-10-2007 | Original Contributions

Number and Size of Lymph Nodes Recovered From Dukes B Rectal Cancers: Correlation with Prognosis and Histologic Antitumor Immune Response

Authors: John Murphy, M.B., Marc Pocard, M.D., Jeremy R. Jass, M.D., F.R.C.Path., Gerald C. O’Sullivan, M.Ch., F.R.C.S.I., Garry Lee, M.B., F.R.C.Path., Ian C. Talbot, M.D., F.R.C.Path.

Published in: Diseases of the Colon & Rectum | Issue 10/2007

Abstract

Purpose

In rectal cancer variation in lymph node recovery influences the detection of nodal metastases and prognosis among Dukes B (Stage II) cases. However, the possible prognostic importance of node size and inherent patient/tumor characteristics in determining node recovery has not been studied.

Methods

We examined 269 Dukes B (Stage II) rectal tumors, with a mean of 12 nodes per case. Primary tumor characteristics were correlated with the number and size of recovered nodes. Clinical follow-up permitted determination of long-term survival.

Results

The five-year survival of 94 Dukes B cases with nine or fewer nodes was 69.4 percent vs. 87.6 percent in 175 cases with ten or more nodes (P = 0.001). Lymph nodes were smaller in patients dying of recurrence; among 130 Dukes B patients whose mean node diameter was <4 mm, survival was 73.3 vs. 88 percent when mean nodal diameter was ≥4 mm. The number and size of recovered nodes was related to patient age, histologic antitumor immune response, and tumor growth pattern. By combining the number and size of nodes, a poor prognosis subgroup of 98 Dukes B patients with relatively few large nodes (no more than 5 measuring ≥4 mm) was identified with a five-year survival of 65.6 percent compared with 89.6 percent for the remaining 158 Dukes B cases (P < 0.0001).

Conclusions

In Dukes B rectal tumors, the number and size of lymph nodes are related to inherent patient and tumor characteristics and permit the identification of Dukes B cases at increased risk of recurrence. A valid comparison of nodal sampling efficiency between centers necessitates measuring and counting harvested lymph nodes.

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Title: Number and Size of Lymph Nodes Recovered From Dukes B Rectal Cancers: Correlation with Prognosis and Histologic Antitumor Immune Response
Authors: John Murphy, M.B.
Marc Pocard, M.D.
Jeremy R. Jass, M.D., F.R.C.Path.
Gerald C. O’Sullivan, M.Ch., F.R.C.S.I.
Garry Lee, M.B., F.R.C.Path.
Ian C. Talbot, M.D., F.R.C.Path.
Publication date: 01-10-2007
Publisher: Springer-Verlag
Published in: Diseases of the Colon & Rectum / Issue 10/2007
Print ISSN: 0012-3706
Electronic ISSN: 1530-0358
DOI: https://doi.org/10.1007/s10350-007-9024-3

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Number and Size of Lymph Nodes Recovered From Dukes B Rectal Cancers: Correlation with Prognosis and Histologic Antitumor Immune Response

Abstract

Purpose

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

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