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International Journal of Colorectal Disease

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01-04-2020 | Rectal Cancer | Original Article

Risk factors and therapeutic significance of inguinal lymph node metastasis in advanced lower rectal cancer

Authors: Hiroshi Shiratori, Hiroaki Nozawa, Kazushige Kawai, Keisuke Hata, Toshiaki Tanaka, Manabu Kaneko, Shigenobu Emoto, Hirofumi Sonoda, Soichiro Ishihara

Published in: International Journal of Colorectal Disease | Issue 4/2020

Abstract

Purpose

This study aimed to clarify predictors and therapeutic significance of inguinal lymph node metastasis (ILNM) in patients with rectal cancer.

Methods

Patients with rectal adenocarcinoma invading the anal canal who underwent curative surgery between 2003 and 2019 were retrospectively reviewed. Synchronous and metachronous lymph node (LN) metastasis were collectively defined as final nodal metastasis (f-LNM). Factors associated with f-LNM were analyzed. Moreover, the “modified therapeutic value index,” defined by multiplication of the frequency of f-LNM by the 5-year overall survival rate for patients who received treatment for f-LNM, was calculated for each LN area.

Results

A total of 145 patients were enrolled (16 patients with f-ILNM). To predict f-ILNM, the cutoff of the inguinal lymph node (ILN) diameter of 8.5 mm gave an area under the curve of 0.889. Dentate line involvement (odds ratio 33.4) and ILN larger than the cutoff of 8 mm (odds ratio 11.9) were independently associated with f-ILNM. The modified therapeutic value indices of the inguinal, lateral pelvic, and mesorectal LNs in the entire population were 6.1, 8.2, and 20.3 points, respectively. In patients with dentate line invasion by cancer, the index of the ILN increased to 11.7 points. In patients with an ILN > 8 mm, the index further increased to 21.1 points.

Conclusion

Dentate line involvement and ILN > 8 mm predicted the development of ILNM in patients with rectal cancer invading the anal canal. Treatment of the ILN should be considered for patients with the above predictors given the significant therapeutic outcomes.

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Title: Risk factors and therapeutic significance of inguinal lymph node metastasis in advanced lower rectal cancer
Authors: Hiroshi Shiratori
Hiroaki Nozawa
Kazushige Kawai
Keisuke Hata
Toshiaki Tanaka
Manabu Kaneko
Shigenobu Emoto
Hirofumi Sonoda
Soichiro Ishihara
Publication date: 01-04-2020
Publisher: Springer Berlin Heidelberg
Keywords: Rectal Cancer
Metastasis
Rectal Cancer
Published in: International Journal of Colorectal Disease / Issue 4/2020
Print ISSN: 0179-1958
Electronic ISSN: 1432-1262
DOI: https://doi.org/10.1007/s00384-020-03520-2

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Springer Medicine

Risk factors and therapeutic significance of inguinal lymph node metastasis in advanced lower rectal cancer

Abstract

Purpose

Methods

Results

Conclusion

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

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