Radiological assessment of persistent retroperitoneal and lateral pelvic lymph nodes after neoadjuvant therapy for rectal cancer: An analysis of the United States Rectal Cancer Consortium
Introduction Management of retroperitoneal and lateral pelvic lymph nodes (RLPN) in rectal cancer remains unclear. With total neoadjuvant therapy (TNT), more patients have radiologic complete clinical response (rCR). We sought to evaluate the impact of radiographic persistent RLPN after neoadjuvant...
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| Veröffentlicht in: | Journal of surgical oncology 2021-10, Vol.124 (5), p.818-828 |
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| creator | Turgeon, Michael K. Gamboa, Adriana C. Keilson, Jessica M. Maniko, Jeffrey Maguire, Lillias Hrebinko, Katherine Holder‐Murray, Jennifer Wiseman, Jason T. Abdel‐Misih, Sherif Hamdan, Saif Hawkins, Alexander T. Bauer, Philip Silviera, Matthew Maithel, Shishir K. Balch, Glen C. |
| description | Introduction
Management of retroperitoneal and lateral pelvic lymph nodes (RLPN) in rectal cancer remains unclear. With total neoadjuvant therapy (TNT), more patients have radiologic complete clinical response (rCR). We sought to evaluate the impact of radiographic persistent RLPN after neoadjuvant therapy on survival.
Materials and Methods
Patients with rectal adenocarcinoma with isolated RLPN metastasis, who received neoadjuvant therapy before surgery were included from the United States Rectal Cancer Consortium database. Primary outcomes were recurrence‐free survival (RFS) and overall survival (OS).
Results
Of 77 patients, all received neoadjuvant therapy, with 35 (46%) receiving TNT. Posttreatment, 33 (43%) had rCR while 44 (57%) had radiographic persistent RLPN. Median number of radiographic positive RLPN was 1 (IQR 1–2).
Receipt of TNT was associated with radiographic RLPN rCR (OR 4.77, 95% CI 1.81–12.60, p .05).
Conclusions
Radiographic persistence of RLPN was not associated with worse survival in well‐selected patients and may not be a reliable indicator of pathological response. TNT may be the preferred management strategy to select patients given its association with rCR. Radiographic persistence of RLPN after preoperative therapy should not necessarily preclude surgery. |
| doi_str_mv | 10.1002/jso.26600 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_8433488</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2552993368</sourcerecordid><originalsourceid>FETCH-LOGICAL-c3800-d71bca001c79463ba4991bcf5e1df9b4b1f683275abef500a3665669b74e34e33</originalsourceid><addsrcrecordid>eNqNks1q3DAQx01pabZpD30DQS8tZRPZsiWrh0Aw_SQQSJqzkOVxVostuZK8ZZ-tL9dxdgm0UCgIpNH85j-j0WTZ65ye5ZQW59vozwrOKX2SrXIq-VpSWT_NVugr1qWQ9CR7EeOWUiolL59nJ6wsBBpilf260Z31g7-3Rg9ExwgxjuAS8T2ZIEQb02IFSMGjbZN3sICuI4NOEPA8wbCzhgz7cdoQ5zuIRPfoIg687rbzTqNA2iA77UnvA4qZhHFGOwPhA7l0KKeHPeZasiJJ7pxN0JHbhCkiuTnwzQNPGu-iD8nO48vsWa-HCK-O-2l29-nj9-bL-ur689fm8mptWE3puhN5azSluRGy5KzVpZR401eQd71syzbvec0KUekW-opSzTivOJetKIHhYqfZxUF3mtsROoMNwXerKdhRh73y2qo_Pc5u1L3fqbpkrKxrFHh7FAj-xwwxqdFGA8OgsUVzVEVVFVIyxhf0zV_o1s8B27NQgjJBRZUj9e5AmeBjDNA_FpNTtYyEwpFQDyOB7PsD-xNa30djAdv4yONMcFHSKi_xRBfl-v_pxuIHWe8aP7uEoefHUDvA_t8VqW-314fSfgO-Q9yX</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2570370751</pqid></control><display><type>article</type><title>Radiological assessment of persistent retroperitoneal and lateral pelvic lymph nodes after neoadjuvant therapy for rectal cancer: An analysis of the United States Rectal Cancer Consortium</title><source>Access via Wiley Online Library</source><source>Web of Science - Science Citation Index Expanded - 2021<img src="https://exlibris-pub.s3.amazonaws.com/fromwos-v2.jpg" /></source><creator>Turgeon, Michael K. ; Gamboa, Adriana C. ; Keilson, Jessica M. ; Maniko, Jeffrey ; Maguire, Lillias ; Hrebinko, Katherine ; Holder‐Murray, Jennifer ; Wiseman, Jason T. ; Abdel‐Misih, Sherif ; Hamdan, Saif ; Hawkins, Alexander T. ; Bauer, Philip ; Silviera, Matthew ; Maithel, Shishir K. ; Balch, Glen C.</creator><creatorcontrib>Turgeon, Michael K. ; Gamboa, Adriana C. ; Keilson, Jessica M. ; Maniko, Jeffrey ; Maguire, Lillias ; Hrebinko, Katherine ; Holder‐Murray, Jennifer ; Wiseman, Jason T. ; Abdel‐Misih, Sherif ; Hamdan, Saif ; Hawkins, Alexander T. ; Bauer, Philip ; Silviera, Matthew ; Maithel, Shishir K. ; Balch, Glen C.</creatorcontrib><description>Introduction
Management of retroperitoneal and lateral pelvic lymph nodes (RLPN) in rectal cancer remains unclear. With total neoadjuvant therapy (TNT), more patients have radiologic complete clinical response (rCR). We sought to evaluate the impact of radiographic persistent RLPN after neoadjuvant therapy on survival.
Materials and Methods
Patients with rectal adenocarcinoma with isolated RLPN metastasis, who received neoadjuvant therapy before surgery were included from the United States Rectal Cancer Consortium database. Primary outcomes were recurrence‐free survival (RFS) and overall survival (OS).
Results
Of 77 patients, all received neoadjuvant therapy, with 35 (46%) receiving TNT. Posttreatment, 33 (43%) had rCR while 44 (57%) had radiographic persistent RLPN. Median number of radiographic positive RLPN was 1 (IQR 1–2).
Receipt of TNT was associated with radiographic RLPN rCR (OR 4.77, 95% CI 1.81–12.60, p < .01). However, there was no difference in RFS and OS between patients who achieved rCR or with persistent RLPN (all p > .05).
Conclusions
Radiographic persistence of RLPN was not associated with worse survival in well‐selected patients and may not be a reliable indicator of pathological response. TNT may be the preferred management strategy to select patients given its association with rCR. Radiographic persistence of RLPN after preoperative therapy should not necessarily preclude surgery.</description><identifier>ISSN: 0022-4790</identifier><identifier>EISSN: 1096-9098</identifier><identifier>DOI: 10.1002/jso.26600</identifier><identifier>PMID: 34270097</identifier><language>eng</language><publisher>HOBOKEN: Wiley</publisher><subject>Cancer therapies ; Colorectal cancer ; Consortia ; Life Sciences & Biomedicine ; Lymphatic system ; neoadjuvant therapy ; Oncology ; rectal cancer ; retroperitoneal lateral pelvic lymph nodes ; Science & Technology ; Surgery ; total neoadjuvant therapy</subject><ispartof>Journal of surgical oncology, 2021-10, Vol.124 (5), p.818-828</ispartof><rights>2021 Wiley Periodicals LLC</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>true</woscitedreferencessubscribed><woscitedreferencescount>1</woscitedreferencescount><woscitedreferencesoriginalsourcerecordid>wos000674051400001</woscitedreferencesoriginalsourcerecordid><cites>FETCH-LOGICAL-c3800-d71bca001c79463ba4991bcf5e1df9b4b1f683275abef500a3665669b74e34e33</cites><orcidid>0000-0001-7197-9007 ; 0000-0002-6041-2416 ; 0000-0002-5464-2178</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1002%2Fjso.26600$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1002%2Fjso.26600$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>230,315,782,786,887,1419,27933,27934,39267,45583,45584</link.rule.ids></links><search><creatorcontrib>Turgeon, Michael K.</creatorcontrib><creatorcontrib>Gamboa, Adriana C.</creatorcontrib><creatorcontrib>Keilson, Jessica M.</creatorcontrib><creatorcontrib>Maniko, Jeffrey</creatorcontrib><creatorcontrib>Maguire, Lillias</creatorcontrib><creatorcontrib>Hrebinko, Katherine</creatorcontrib><creatorcontrib>Holder‐Murray, Jennifer</creatorcontrib><creatorcontrib>Wiseman, Jason T.</creatorcontrib><creatorcontrib>Abdel‐Misih, Sherif</creatorcontrib><creatorcontrib>Hamdan, Saif</creatorcontrib><creatorcontrib>Hawkins, Alexander T.</creatorcontrib><creatorcontrib>Bauer, Philip</creatorcontrib><creatorcontrib>Silviera, Matthew</creatorcontrib><creatorcontrib>Maithel, Shishir K.</creatorcontrib><creatorcontrib>Balch, Glen C.</creatorcontrib><title>Radiological assessment of persistent retroperitoneal and lateral pelvic lymph nodes after neoadjuvant therapy for rectal cancer: An analysis of the United States Rectal Cancer Consortium</title><title>Journal of surgical oncology</title><addtitle>J SURG ONCOL</addtitle><description>Introduction
Management of retroperitoneal and lateral pelvic lymph nodes (RLPN) in rectal cancer remains unclear. With total neoadjuvant therapy (TNT), more patients have radiologic complete clinical response (rCR). We sought to evaluate the impact of radiographic persistent RLPN after neoadjuvant therapy on survival.
Materials and Methods
Patients with rectal adenocarcinoma with isolated RLPN metastasis, who received neoadjuvant therapy before surgery were included from the United States Rectal Cancer Consortium database. Primary outcomes were recurrence‐free survival (RFS) and overall survival (OS).
Results
Of 77 patients, all received neoadjuvant therapy, with 35 (46%) receiving TNT. Posttreatment, 33 (43%) had rCR while 44 (57%) had radiographic persistent RLPN. Median number of radiographic positive RLPN was 1 (IQR 1–2).
Receipt of TNT was associated with radiographic RLPN rCR (OR 4.77, 95% CI 1.81–12.60, p < .01). However, there was no difference in RFS and OS between patients who achieved rCR or with persistent RLPN (all p > .05).
Conclusions
Radiographic persistence of RLPN was not associated with worse survival in well‐selected patients and may not be a reliable indicator of pathological response. TNT may be the preferred management strategy to select patients given its association with rCR. Radiographic persistence of RLPN after preoperative therapy should not necessarily preclude surgery.</description><subject>Cancer therapies</subject><subject>Colorectal cancer</subject><subject>Consortia</subject><subject>Life Sciences & Biomedicine</subject><subject>Lymphatic system</subject><subject>neoadjuvant therapy</subject><subject>Oncology</subject><subject>rectal cancer</subject><subject>retroperitoneal lateral pelvic lymph nodes</subject><subject>Science & Technology</subject><subject>Surgery</subject><subject>total neoadjuvant therapy</subject><issn>0022-4790</issn><issn>1096-9098</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><sourceid>HGBXW</sourceid><recordid>eNqNks1q3DAQx01pabZpD30DQS8tZRPZsiWrh0Aw_SQQSJqzkOVxVostuZK8ZZ-tL9dxdgm0UCgIpNH85j-j0WTZ65ye5ZQW59vozwrOKX2SrXIq-VpSWT_NVugr1qWQ9CR7EeOWUiolL59nJ6wsBBpilf260Z31g7-3Rg9ExwgxjuAS8T2ZIEQb02IFSMGjbZN3sICuI4NOEPA8wbCzhgz7cdoQ5zuIRPfoIg687rbzTqNA2iA77UnvA4qZhHFGOwPhA7l0KKeHPeZasiJJ7pxN0JHbhCkiuTnwzQNPGu-iD8nO48vsWa-HCK-O-2l29-nj9-bL-ur689fm8mptWE3puhN5azSluRGy5KzVpZR401eQd71syzbvec0KUekW-opSzTivOJetKIHhYqfZxUF3mtsROoMNwXerKdhRh73y2qo_Pc5u1L3fqbpkrKxrFHh7FAj-xwwxqdFGA8OgsUVzVEVVFVIyxhf0zV_o1s8B27NQgjJBRZUj9e5AmeBjDNA_FpNTtYyEwpFQDyOB7PsD-xNa30djAdv4yONMcFHSKi_xRBfl-v_pxuIHWe8aP7uEoefHUDvA_t8VqW-314fSfgO-Q9yX</recordid><startdate>20211001</startdate><enddate>20211001</enddate><creator>Turgeon, Michael K.</creator><creator>Gamboa, Adriana C.</creator><creator>Keilson, Jessica M.</creator><creator>Maniko, Jeffrey</creator><creator>Maguire, Lillias</creator><creator>Hrebinko, Katherine</creator><creator>Holder‐Murray, Jennifer</creator><creator>Wiseman, Jason T.</creator><creator>Abdel‐Misih, Sherif</creator><creator>Hamdan, Saif</creator><creator>Hawkins, Alexander T.</creator><creator>Bauer, Philip</creator><creator>Silviera, Matthew</creator><creator>Maithel, Shishir K.</creator><creator>Balch, Glen C.</creator><general>Wiley</general><general>Wiley Subscription Services, Inc</general><scope>BLEPL</scope><scope>DTL</scope><scope>HGBXW</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>K9.</scope><scope>7X8</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0001-7197-9007</orcidid><orcidid>https://orcid.org/0000-0002-6041-2416</orcidid><orcidid>https://orcid.org/0000-0002-5464-2178</orcidid></search><sort><creationdate>20211001</creationdate><title>Radiological assessment of persistent retroperitoneal and lateral pelvic lymph nodes after neoadjuvant therapy for rectal cancer: An analysis of the United States Rectal Cancer Consortium</title><author>Turgeon, Michael K. ; Gamboa, Adriana C. ; Keilson, Jessica M. ; Maniko, Jeffrey ; Maguire, Lillias ; Hrebinko, Katherine ; Holder‐Murray, Jennifer ; Wiseman, Jason T. ; Abdel‐Misih, Sherif ; Hamdan, Saif ; Hawkins, Alexander T. ; Bauer, Philip ; Silviera, Matthew ; Maithel, Shishir K. ; Balch, Glen C.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3800-d71bca001c79463ba4991bcf5e1df9b4b1f683275abef500a3665669b74e34e33</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Cancer therapies</topic><topic>Colorectal cancer</topic><topic>Consortia</topic><topic>Life Sciences & Biomedicine</topic><topic>Lymphatic system</topic><topic>neoadjuvant therapy</topic><topic>Oncology</topic><topic>rectal cancer</topic><topic>retroperitoneal lateral pelvic lymph nodes</topic><topic>Science & Technology</topic><topic>Surgery</topic><topic>total neoadjuvant therapy</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Turgeon, Michael K.</creatorcontrib><creatorcontrib>Gamboa, Adriana C.</creatorcontrib><creatorcontrib>Keilson, Jessica M.</creatorcontrib><creatorcontrib>Maniko, Jeffrey</creatorcontrib><creatorcontrib>Maguire, Lillias</creatorcontrib><creatorcontrib>Hrebinko, Katherine</creatorcontrib><creatorcontrib>Holder‐Murray, Jennifer</creatorcontrib><creatorcontrib>Wiseman, Jason T.</creatorcontrib><creatorcontrib>Abdel‐Misih, Sherif</creatorcontrib><creatorcontrib>Hamdan, Saif</creatorcontrib><creatorcontrib>Hawkins, Alexander T.</creatorcontrib><creatorcontrib>Bauer, Philip</creatorcontrib><creatorcontrib>Silviera, Matthew</creatorcontrib><creatorcontrib>Maithel, Shishir K.</creatorcontrib><creatorcontrib>Balch, Glen C.</creatorcontrib><collection>Web of Science Core Collection</collection><collection>Science Citation Index Expanded</collection><collection>Web of Science - Science Citation Index Expanded - 2021</collection><collection>CrossRef</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Journal of surgical oncology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Turgeon, Michael K.</au><au>Gamboa, Adriana C.</au><au>Keilson, Jessica M.</au><au>Maniko, Jeffrey</au><au>Maguire, Lillias</au><au>Hrebinko, Katherine</au><au>Holder‐Murray, Jennifer</au><au>Wiseman, Jason T.</au><au>Abdel‐Misih, Sherif</au><au>Hamdan, Saif</au><au>Hawkins, Alexander T.</au><au>Bauer, Philip</au><au>Silviera, Matthew</au><au>Maithel, Shishir K.</au><au>Balch, Glen C.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Radiological assessment of persistent retroperitoneal and lateral pelvic lymph nodes after neoadjuvant therapy for rectal cancer: An analysis of the United States Rectal Cancer Consortium</atitle><jtitle>Journal of surgical oncology</jtitle><stitle>J SURG ONCOL</stitle><date>2021-10-01</date><risdate>2021</risdate><volume>124</volume><issue>5</issue><spage>818</spage><epage>828</epage><pages>818-828</pages><issn>0022-4790</issn><eissn>1096-9098</eissn><abstract>Introduction
Management of retroperitoneal and lateral pelvic lymph nodes (RLPN) in rectal cancer remains unclear. With total neoadjuvant therapy (TNT), more patients have radiologic complete clinical response (rCR). We sought to evaluate the impact of radiographic persistent RLPN after neoadjuvant therapy on survival.
Materials and Methods
Patients with rectal adenocarcinoma with isolated RLPN metastasis, who received neoadjuvant therapy before surgery were included from the United States Rectal Cancer Consortium database. Primary outcomes were recurrence‐free survival (RFS) and overall survival (OS).
Results
Of 77 patients, all received neoadjuvant therapy, with 35 (46%) receiving TNT. Posttreatment, 33 (43%) had rCR while 44 (57%) had radiographic persistent RLPN. Median number of radiographic positive RLPN was 1 (IQR 1–2).
Receipt of TNT was associated with radiographic RLPN rCR (OR 4.77, 95% CI 1.81–12.60, p < .01). However, there was no difference in RFS and OS between patients who achieved rCR or with persistent RLPN (all p > .05).
Conclusions
Radiographic persistence of RLPN was not associated with worse survival in well‐selected patients and may not be a reliable indicator of pathological response. TNT may be the preferred management strategy to select patients given its association with rCR. Radiographic persistence of RLPN after preoperative therapy should not necessarily preclude surgery.</abstract><cop>HOBOKEN</cop><pub>Wiley</pub><pmid>34270097</pmid><doi>10.1002/jso.26600</doi><tpages>11</tpages><orcidid>https://orcid.org/0000-0001-7197-9007</orcidid><orcidid>https://orcid.org/0000-0002-6041-2416</orcidid><orcidid>https://orcid.org/0000-0002-5464-2178</orcidid><oa>free_for_read</oa></addata></record> |
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| subjects | Cancer therapies Colorectal cancer Consortia Life Sciences & Biomedicine Lymphatic system neoadjuvant therapy Oncology rectal cancer retroperitoneal lateral pelvic lymph nodes Science & Technology Surgery total neoadjuvant therapy |
| title | Radiological assessment of persistent retroperitoneal and lateral pelvic lymph nodes after neoadjuvant therapy for rectal cancer: An analysis of the United States Rectal Cancer Consortium |
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