The prognostic impact of the number of lymph nodes retrieved after neoadjuvant chemoradiotherapy with mesorectal excision for rectal cancer

YoungWan Kim, Namkyu Kim, Byung Soh Min, Kang Young Lee, Seung Kook Sohn, Chang Hwan Cho, Hoguen Kim, K. Chang Keum, Jung Bai Ahn

Research output: Contribution to journalArticle

28 Citations (Scopus)

Abstract

Background: We aimed to assess factors associated with the number of nodes retrieved and the impact of the number of lymph nodes in rectal cancer patients who underwent neoadjuvant chemoradiation with radical surgery. Methods: A total of 258 patients were enrolled. Lymph nodes were retrieved from specimens using a manual dissection technique. Results: Of the 258 patients, nine patients had an absence of lymph nodes (ypNx), 150 patients had a node-negative status (ypN(-)) and 99 patients had node-positive disease (ypN(+)). An advanced ypT classification (ypT3,4) and larger tumor (>4 cm) were associated with an increased number of nodes retrieved. The pretreatment CEA level (>5 ng/ml) and ypN(+) classification were significant risk factors for cancer specific and recurrence free survival. There was no significant difference of oncological outcomes among ypNx patients and a subset of ypN(-) patients based on the number of nodes retrieved using three cutoff values (1-11, 12-25, and 25-65 nodes). Conclusions: In a neoadjuvant setting, ypN(+) disease was an independent risk factor for oncological outcomes. An absence of nodes does not represent an inferior oncological outcome. The number of nodes does not seen to impact survival and recurrence in ypN(-) patients.

Original languageEnglish
Pages (from-to)1-7
Number of pages7
JournalJournal of Surgical Oncology
Volume100
Issue number1
DOIs
Publication statusPublished - 2009 Jul 1

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Chemoradiotherapy
Rectal Neoplasms
Lymph Nodes
Recurrence
Survival
Dissection
Neoplasms

All Science Journal Classification (ASJC) codes

  • Surgery
  • Oncology

Cite this

Kim, YoungWan ; Kim, Namkyu ; Min, Byung Soh ; Lee, Kang Young ; Sohn, Seung Kook ; Cho, Chang Hwan ; Kim, Hoguen ; Keum, K. Chang ; Ahn, Jung Bai. / The prognostic impact of the number of lymph nodes retrieved after neoadjuvant chemoradiotherapy with mesorectal excision for rectal cancer. In: Journal of Surgical Oncology. 2009 ; Vol. 100, No. 1. pp. 1-7.
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abstract = "Background: We aimed to assess factors associated with the number of nodes retrieved and the impact of the number of lymph nodes in rectal cancer patients who underwent neoadjuvant chemoradiation with radical surgery. Methods: A total of 258 patients were enrolled. Lymph nodes were retrieved from specimens using a manual dissection technique. Results: Of the 258 patients, nine patients had an absence of lymph nodes (ypNx), 150 patients had a node-negative status (ypN(-)) and 99 patients had node-positive disease (ypN(+)). An advanced ypT classification (ypT3,4) and larger tumor (>4 cm) were associated with an increased number of nodes retrieved. The pretreatment CEA level (>5 ng/ml) and ypN(+) classification were significant risk factors for cancer specific and recurrence free survival. There was no significant difference of oncological outcomes among ypNx patients and a subset of ypN(-) patients based on the number of nodes retrieved using three cutoff values (1-11, 12-25, and 25-65 nodes). Conclusions: In a neoadjuvant setting, ypN(+) disease was an independent risk factor for oncological outcomes. An absence of nodes does not represent an inferior oncological outcome. The number of nodes does not seen to impact survival and recurrence in ypN(-) patients.",
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The prognostic impact of the number of lymph nodes retrieved after neoadjuvant chemoradiotherapy with mesorectal excision for rectal cancer. / Kim, YoungWan; Kim, Namkyu; Min, Byung Soh; Lee, Kang Young; Sohn, Seung Kook; Cho, Chang Hwan; Kim, Hoguen; Keum, K. Chang; Ahn, Jung Bai.

In: Journal of Surgical Oncology, Vol. 100, No. 1, 01.07.2009, p. 1-7.

Research output: Contribution to journalArticle

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AU - Kim, YoungWan

AU - Kim, Namkyu

AU - Min, Byung Soh

AU - Lee, Kang Young

AU - Sohn, Seung Kook

AU - Cho, Chang Hwan

AU - Kim, Hoguen

AU - Keum, K. Chang

AU - Ahn, Jung Bai

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N2 - Background: We aimed to assess factors associated with the number of nodes retrieved and the impact of the number of lymph nodes in rectal cancer patients who underwent neoadjuvant chemoradiation with radical surgery. Methods: A total of 258 patients were enrolled. Lymph nodes were retrieved from specimens using a manual dissection technique. Results: Of the 258 patients, nine patients had an absence of lymph nodes (ypNx), 150 patients had a node-negative status (ypN(-)) and 99 patients had node-positive disease (ypN(+)). An advanced ypT classification (ypT3,4) and larger tumor (>4 cm) were associated with an increased number of nodes retrieved. The pretreatment CEA level (>5 ng/ml) and ypN(+) classification were significant risk factors for cancer specific and recurrence free survival. There was no significant difference of oncological outcomes among ypNx patients and a subset of ypN(-) patients based on the number of nodes retrieved using three cutoff values (1-11, 12-25, and 25-65 nodes). Conclusions: In a neoadjuvant setting, ypN(+) disease was an independent risk factor for oncological outcomes. An absence of nodes does not represent an inferior oncological outcome. The number of nodes does not seen to impact survival and recurrence in ypN(-) patients.

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