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Open Access 01-09-2020 | Rectal Cancer | Original Article

The prognostic impact of neoadjuvant chemoradiotherapy on lymph node sampling in patients with locally advanced rectal cancer

Authors: Giovanni Li Destri, Andrea Maugeri, Alice Ramistella, Gaetano La Greca, Pietro Conti, Giovanni Trombatore, Giada Maria Vecchio, Gaetano Giuseppe Magro, Martina Barchitta, Antonella Agodi

Published in: Updates in Surgery | Issue 3/2020

Abstract

According to the American Joint Committee on Cancer, at least 12 lymph nodes are required to accurately stage locally advanced rectal cancer (LARC). Neoadjuvant chemoradiation therapy (NACRT) reduces the number of lymph nodes retrieved during surgery. In this study, we evaluated the effect of NACRT on lymph node retrieval and prognosis in patients with LARC. We performed an observational study of 142 patients with LARC. Although our analysis was retrospective, data were collected prospectively. Half the patients were treated with NACRT and total mesorectal excision (TME) and the other half underwent TME only. The number of lymph nodes retrieved and the number of metastatic lymph nodes were significantly reduced in the NACRT group (P > 0.001). In the univariate and multivariate analyses, only NACRT and patient age were significantly associated with reduced lymph node retrieval. The number of metastatic lymph nodes and the lymph node ratio (LNR) both had a significant effect on prognosis when the patient population was examined as a whole (P = 0.003 and P = 0.001, respectively). However, the LNR was the only significant, independent prognostic factor in both treatment groups (P = 0.007 for the NACRT group; P = 0.04 for the no-NACRT group). NACRT improves patient prognosis only when the number of metastatic lymph nodes is reduced. The number of metastatic lymph nodes and the LNR are important prognostic factors. Lymph node retrieval remains an indispensable tool for staging and prognostic assessment of patients with rectal carcinoma treated with NACRT.

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Title: The prognostic impact of neoadjuvant chemoradiotherapy on lymph node sampling in patients with locally advanced rectal cancer
Authors: Giovanni Li Destri
Andrea Maugeri
Alice Ramistella
Gaetano La Greca
Pietro Conti
Giovanni Trombatore
Giada Maria Vecchio
Gaetano Giuseppe Magro
Martina Barchitta
Antonella Agodi
Publication date: 01-09-2020
Publisher: Springer International Publishing
Keywords: Rectal Cancer
Rectal Cancer
Published in: Updates in Surgery / Issue 3/2020
Print ISSN: 2038-131X
Electronic ISSN: 2038-3312
DOI: https://doi.org/10.1007/s13304-020-00841-3

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The prognostic impact of neoadjuvant chemoradiotherapy on lymph node sampling in patients with locally advanced rectal cancer

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