Prognostic Importance Of Lymph Node Count And Ratio In Rectal Cancer After Neoadjuvant Chemoradiotherapy: Results From A Cross-Sectional Study

JOURNAL OF SURGICAL ONCOLOGY(2021)

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摘要
Background: The aim of this study was to determine the prognostic value of lymph node count (LNC) and lymph node ratio (LNR) in rectal cancer after neoadjuvant chemoradiotherapy (CRT).Methods: Patients who underwent neoadjuvant CRT and total mesorectal excision (TME) for Stage I-III rectal cancer were selected from a cross-sectional study including 71 Dutch centres. Primary outcome parameters were disease-free survival (DFS) and overall survival (OS). Prognostic significance of LNC and LNR (cut-off values 0.15, 0.20, 0.30) was tested for different (sub)groups.Results: From 2095 registered patients, 458 were included, of which 240 patients with LNC < 12 and 218 patients with LNC >= 12. LNC was not significantly associated with DFS (p = 0.35) and OS (p = 0.59). In univariable analysis, LNR was significantly associated with DFS and OS in the whole cohort and LNC subgroups, but not in multivariable analysis.Conclusions: LNC was not associated with long-term oncological outcome in rectal cancer patients treated with CRT, nor was LNR when corrected for N-stage. However, LNR might be used to identify subgroups of node-positive patients with a favourable outcome.
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关键词
chemoradiotherapy, disease-free survival, lymph nodes, rectal cancer, survival
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