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Langenbeck's Archives of Surgery

Published in:

01-09-2007 | Original Article

Morphological characteristics of lateral pelvic lymph nodes in rectal carcinoma

Authors: Hiroyoshi Matsuoka, Tadahiko Masaki, Masanori Sugiyama, Yutaka Atomi, Yasuo Ohkura, Atsuhiko Sakamoto

Published in: Langenbeck's Archives of Surgery | Issue 5/2007

Abstract

Aim

Macroscopic and imaging indicators for lymph node metastasis have been documented not in lateral pelvic lymph nodes but in mesorectal lymph nodes in patients with rectal carcinoma. We conducted this study to uncover morphological characteristics of lateral pelvic lymph nodes in patients with rectal carcinoma.

Materials and methods

Fifty-eight patients with locally advanced rectal carcinoma who had total mesorectal excision and lateral pelvic lymph node dissection were studied. Total number of lateral pelvic lymph nodes evaluated was 462, with 538 mesorectal lymph nodes being used for comparison. Factors of lymph nodes evaluated were size (long- and short-axes diameters), shape (ovoid and irregular), and heterogeneity of internal structure. Receiver operating characteristic (ROC) curve analysis was used to compare the diagnostic accuracy of each factor.

Results

Lateral pelvic lymph node at non-metastatic status appeared to be longer (4.5 vs 3.5 mm) and thinner (2.2 vs 2.6 mm) than mesorectal lymph nodes. ROC curve analysis, for discriminating non-metastatic and metastatic lateral pelvic lymph nodes, revealed that a short-axis diameter appeared to be the most prominent factor with highest area under curve (0.907) and was more reliable than either long-axis diameter (0.811) or shape (0.527) other than internal structure (1.00). A short-axis diameter was an independent risk factor for metastasis by multivariate analysis with an odds ratio of 1.29 (p < 0.0001, 95% confident interval, 1.22–1.36). The most reliable cut-off value was 4 mm with 96% of sensitivity, 68% of specificity, and 82% of overall accuracy.

Conclusion

Lateral pelvic lymph nodes tended to be longer and thinner than mesorectal lymph nodes at non-metastatic status. A short-axis diameter of 4 mm or larger was the prominent indicator of metastasis in lateral pelvic lymph nodes.

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Title: Morphological characteristics of lateral pelvic lymph nodes in rectal carcinoma
Authors: Hiroyoshi Matsuoka
Tadahiko Masaki
Masanori Sugiyama
Yutaka Atomi
Yasuo Ohkura
Atsuhiko Sakamoto
Publication date: 01-09-2007
Publisher: Springer-Verlag
Published in: Langenbeck's Archives of Surgery / Issue 5/2007
Print ISSN: 1435-2443
Electronic ISSN: 1435-2451
DOI: https://doi.org/10.1007/s00423-007-0181-6

At a glance: The STEP trials

Springer Medicine

Morphological characteristics of lateral pelvic lymph nodes in rectal carcinoma

Abstract

Aim

Materials and methods

Results

Conclusion

At a glance: The STEP trials

Springer Medicine

Abstract

Aim

Materials and methods

Results

Conclusion

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