The Effect of Lymph Node Harvest on Prognosis in Locally Advanced Middle-Low Rectal Cancer After Neoadjuvant Chemoradiotherapy

Frontiers in Oncology

Zhuangbin Lin³  Rong Zheng⁵  Anchuan Li⁵  Benhua Xu⁵  Cheng Chen⁷  Xiaobo Li⁷  Jianyuan Song⁷ 

[1] Department of Medical Imaging Technology, College of Medical Technology and Engineering, Fujian Medical University, Fuzhou, China;Department of Radiation Oncology, Fujian Branch of Shanghai Children’s Medical Center Affiliated to Shanghai Jiaotong University School of Medicine, Fuzhou, China;Department of Radiation Oncology, Fujian Children’s Hospital, Fuzhou, China;Department of Radiation Oncology, Fujian Medical University Union Hospital, Fuzhou, China;School of Clinical Medicine, Fujian Medical University, Fuzhou, China;The Graduate School, Fujian Medical University, Fuzhou, China;Union Clinical Medicine College, Fujian Medical University, Fuzhou, China;

关键词: locally advanced rectal cancer;    neoadjuvant chemoradiotherapy;    lymph nodes retrieved;    prognosis;    PLN;    LNR;   

DOI  :  10.3389/fonc.2022.816485

来源: DOAJ

【 摘 要 】

ObjectiveThe purpose of this study was to investigate the relationship between lymph node harvest and the prognosis in locally advanced rectal cancer (LARC) patients after neoadjuvant chemoradiotherapy (nCRT).MethodsPatients who were diagnosed with clinical LARC and treated with nCRT and radical surgery between June 2008 and July 2017 were included in this study. The relationship between lymph node retrieval and prognosis was analyzed. Other lymph node-related indicators were explored.ResultsA total of 837 patients with a median follow-up of 61 (7-139) months were included in the study. The five-year DFS and OS rates of all patients were 74.9% and 82.3%, respectively. Multivariate survival analysis suggested that dissection of ≥ 12 lymph nodes did not improve OS or DFS. 7 was selected as the best cutoff value for the total number of lymph nodes retrieved by Cox multivariate analysis (χ2 = 10.072, HR: 0.503, P=0.002). Dissection of ≥ 5 positive lymph nodes (PLNs) was an independent prognostic factor for poorer DFS (HR: 2.104, P=0.004) and OS (HR: 3.471, p<0.001). A positive lymph node ratio (LNR) of more than 0.29 was also an independent prognostic factor for poorer DFS (HR: 1.951, P=0.002) and OS (HR: 2.434, p<0.001).ConclusionThe recommends that at least 7 harvested lymph nodes may be more appropriate for LARC patients with nCRT. PLN and LNR may be prognostic factors for LARC patients with ypN+ after nCRT.

【 授权许可】

Unknown