Neoadjuvant Chemoradiotherapy Affects the Indications for Lateral Pelvic Node Dissection in Mid/Low Rectal Cancer with Clinically Suspected Lateral Node Involvement: A Multicenter Retrospective Cohort Study

Background Although lateral pelvic node dissection (LPND) is recommended for rectal cancer with clinically metastatic lateral pelvic lymph nodes (LPNs), LPNs may respond to neoadjuvant chemoradiotherapy (nCRT). Our aim was to determine the optimal indication for LPND after nCRT for mid/low rectal ca...

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Veröffentlicht in:	Annals of surgical oncology 2014-07, Vol.21 (7), p.2280-2287
Hauptverfasser:	Oh, Heung-Kwon, Kang, Sung-Bum, Lee, Sung-Min, Lee, Soo Young, Ihn, Myoung Hun, Kim, Duck-Woo, Park, Ji Hoon, Kim, Young Hoon, Lee, Kyung Ho, Kim, Jae-Sung, Kim, Jin Won, Kim, Jee Hyun, Chang, Tae-Young, Park, Sung-Chan, Sohn, Dae Kyung, Oh, Jae Hwan, Park, Ji Won, Ryoo, Seung-Bum, Jeong, Seung-Yong, Park, Kyu Joo
Format:	Artikel
Sprache:	eng
Schlagworte:	Adult Aged Aged, 80 and over Chemoradiotherapy Colorectal Cancer Combined Modality Therapy Female Follow-Up Studies Humans Lymph Nodes - pathology Lymph Nodes - surgery Lymphatic Metastasis Male Medicine Medicine & Public Health Middle Aged Neoadjuvant Therapy Neoplasm Recurrence, Local - mortality Neoplasm Recurrence, Local - pathology Neoplasm Recurrence, Local - surgery Neoplasm Recurrence, Local - therapy Neoplasm Staging Oncology Pelvic Neoplasms - mortality Pelvic Neoplasms - pathology Pelvic Neoplasms - surgery Pelvic Neoplasms - therapy Preoperative Care Prognosis Rectal Neoplasms - mortality Rectal Neoplasms - pathology Rectal Neoplasms - therapy Retrospective Studies Risk Factors Surgery Surgical Oncology Survival Rate
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Zusammenfassung:	Background Although lateral pelvic node dissection (LPND) is recommended for rectal cancer with clinically metastatic lateral pelvic lymph nodes (LPNs), LPNs may respond to neoadjuvant chemoradiotherapy (nCRT). Our aim was to determine the optimal indication for LPND after nCRT for mid/low rectal cancer. Methods Of 2,263 patients with clinical stage II/III mid/low rectal cancer who were managed at three tertiary referral hospitals, 66 patients underwent curative surgery including LPND after nCRT were included in this study. Risk factors for LPN metastasis were retrospectively analyzed and oncologic outcomes determined according to LPN response to nCRT. Results Persistent LPNs greater than 5 mm on post-nCRT magnetic resonance imaging were significantly associated with residual tumor metastasis, unlike responsive LPN after nCRT (short-axis diameter ≤5 mm) (pathologically, 61.1 % [22 of 36] vs. 0 % [0 of 30], P
ISSN:	1068-9265 1534-4681
DOI:	10.1245/s10434-014-3559-z