Prognostic Value of the Distribution of Lymph Node Metastasis in Locally Advanced Rectal Cancer After Neoadjuvant Chemoradiotherapy

Background: The objective of this study is to assess the prognostic value of lymph node metastasis distribution (LND) in locally advanced rectal cancer (LARC) after neoadjuvant chemoradiotherapy (nCRT).Methods: This study included 179 patients with pathological stage III LARC who underwent nCRT foll...

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Autores principales:	Bin Chen, Xing Liu, Yiyi Zhang, Jinfu Zhuang, Yong Peng, Ye Wang, Yong Wu, Shoufeng Li, Yuanfeng Yang, Guoxian Guan
Formato:	article
Lenguaje:	EN
Publicado:	Frontiers Media S.A. 2021
Materias:	lymph node metastasis rectal cancer neoadjuvant chemoradiotherapy prognosis Surgery RD1-811
Acceso en línea:	https://doaj.org/article/4d7e2320392c41abbab6da7ee7bd9a38
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spelling	oai:doaj.org-article:4d7e2320392c41abbab6da7ee7bd9a382021-11-17T04:46:21ZPrognostic Value of the Distribution of Lymph Node Metastasis in Locally Advanced Rectal Cancer After Neoadjuvant Chemoradiotherapy2296-875X10.3389/fsurg.2021.749575https://doaj.org/article/4d7e2320392c41abbab6da7ee7bd9a382021-11-01T00:00:00Zhttps://www.frontiersin.org/articles/10.3389/fsurg.2021.749575/fullhttps://doaj.org/toc/2296-875XBackground: The objective of this study is to assess the prognostic value of lymph node metastasis distribution (LND) in locally advanced rectal cancer (LARC) after neoadjuvant chemoradiotherapy (nCRT).Methods: This study included 179 patients with pathological stage III LARC who underwent nCRT followed by radical surgery. LND was classified into three groups: LND1, lymph node metastasis at the mesorectum (140/179, 78.2%); LND2, lymph node metastasis along the inferior mesenteric artery trunk nodes (26/179, 14.5%); LND3, lymph node metastasis at the origin of the IMA (13/179, 7.3%). Clinicopathologic characteristics were analyzed to identify independent prognostic factors.Result: LND showed better stratification for 3-year DFS (LND1 66.8, LND2 50, and LND3 15.4%, P < 0.01) compared to the ypN (3-year DFS: N1 59.9 and N2 60.3%, P = 0.34) and ypTNM (3-year DFS: IIIA 68.6%, IIIB 57.5%, and IIIC 53.5, P = 0.19) staging systems. Similar results were found for 3-year LRFS and DMFS. According to multivariate survival analysis, LND was shown to be an independent prognostic factor for DFS, LRFS, and DMFS in patients with positive lymph nodes (P < 0.01, in all cases).Conclusion: LND is an independent prognostic factor in stage III rectal cancer after nCRT. LND can be used as a supplementary indicator for the ypTNM staging system in patients with LARC after nCRT.Bin ChenXing LiuYiyi ZhangJinfu ZhuangYong PengYe WangYong WuShoufeng LiYuanfeng YangGuoxian GuanGuoxian GuanFrontiers Media S.A.articlelymph nodemetastasisrectal cancerneoadjuvant chemoradiotherapyprognosisSurgeryRD1-811ENFrontiers in Surgery, Vol 8 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	lymph node metastasis rectal cancer neoadjuvant chemoradiotherapy prognosis Surgery RD1-811
spellingShingle	lymph node metastasis rectal cancer neoadjuvant chemoradiotherapy prognosis Surgery RD1-811 Bin Chen Xing Liu Yiyi Zhang Jinfu Zhuang Yong Peng Ye Wang Yong Wu Shoufeng Li Yuanfeng Yang Guoxian Guan Guoxian Guan Prognostic Value of the Distribution of Lymph Node Metastasis in Locally Advanced Rectal Cancer After Neoadjuvant Chemoradiotherapy
description	Background: The objective of this study is to assess the prognostic value of lymph node metastasis distribution (LND) in locally advanced rectal cancer (LARC) after neoadjuvant chemoradiotherapy (nCRT).Methods: This study included 179 patients with pathological stage III LARC who underwent nCRT followed by radical surgery. LND was classified into three groups: LND1, lymph node metastasis at the mesorectum (140/179, 78.2%); LND2, lymph node metastasis along the inferior mesenteric artery trunk nodes (26/179, 14.5%); LND3, lymph node metastasis at the origin of the IMA (13/179, 7.3%). Clinicopathologic characteristics were analyzed to identify independent prognostic factors.Result: LND showed better stratification for 3-year DFS (LND1 66.8, LND2 50, and LND3 15.4%, P < 0.01) compared to the ypN (3-year DFS: N1 59.9 and N2 60.3%, P = 0.34) and ypTNM (3-year DFS: IIIA 68.6%, IIIB 57.5%, and IIIC 53.5, P = 0.19) staging systems. Similar results were found for 3-year LRFS and DMFS. According to multivariate survival analysis, LND was shown to be an independent prognostic factor for DFS, LRFS, and DMFS in patients with positive lymph nodes (P < 0.01, in all cases).Conclusion: LND is an independent prognostic factor in stage III rectal cancer after nCRT. LND can be used as a supplementary indicator for the ypTNM staging system in patients with LARC after nCRT.
format	article
author	Bin Chen Xing Liu Yiyi Zhang Jinfu Zhuang Yong Peng Ye Wang Yong Wu Shoufeng Li Yuanfeng Yang Guoxian Guan Guoxian Guan
author_facet	Bin Chen Xing Liu Yiyi Zhang Jinfu Zhuang Yong Peng Ye Wang Yong Wu Shoufeng Li Yuanfeng Yang Guoxian Guan Guoxian Guan
author_sort	Bin Chen
title	Prognostic Value of the Distribution of Lymph Node Metastasis in Locally Advanced Rectal Cancer After Neoadjuvant Chemoradiotherapy
title_short	Prognostic Value of the Distribution of Lymph Node Metastasis in Locally Advanced Rectal Cancer After Neoadjuvant Chemoradiotherapy
title_full	Prognostic Value of the Distribution of Lymph Node Metastasis in Locally Advanced Rectal Cancer After Neoadjuvant Chemoradiotherapy
title_fullStr	Prognostic Value of the Distribution of Lymph Node Metastasis in Locally Advanced Rectal Cancer After Neoadjuvant Chemoradiotherapy
title_full_unstemmed	Prognostic Value of the Distribution of Lymph Node Metastasis in Locally Advanced Rectal Cancer After Neoadjuvant Chemoradiotherapy
title_sort	prognostic value of the distribution of lymph node metastasis in locally advanced rectal cancer after neoadjuvant chemoradiotherapy
publisher	Frontiers Media S.A.
publishDate	2021
url	https://doaj.org/article/4d7e2320392c41abbab6da7ee7bd9a38
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Prognostic Value of the Distribution of Lymph Node Metastasis in Locally Advanced Rectal Cancer After Neoadjuvant Chemoradiotherapy

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