Lymph node status as a prognostic indicator after preoperative neoadjuvant chemoradiotherapy of rectal cancer. (October 2014)

• Record Type: Journal Article
• Authors: Mirbagheri, N.; Kumar, B.; Deb, S.; Poh, B. R.; Dark, J. G.; Leow, C. C.; Teoh, W. M. K.
• Is Part Of: Colorectal disease. Volume 16:Number 10(2014)
• Page Start: O339
• Page End: O346
• Publication Date: 2014-10
• Subjects: Colon (Anatomy) -- Diseases -- Periodicals; Rectum -- Diseases -- Periodicals; 616.34
• DOI: 10.1111/codi.12682
• Languages: English
• ISSNs: 1462-8910

Abstract

<abstract abstract-type="main" id="codi12682-abs-0001"> <title>Abstract</title> <sec id="codi12682-sec-0001" sec-type="section"> <title>Aim</title> <p>The primary aim of this study was to examine lymph node status after neoadjuvant chemoradiotherapy (CRT) using a novel scoring system describing the pathological lymph node regression grade. The proposed scoring system was based on the percentage of fibrosis and the presence of residual tumour amount. The secondary aim of the study was to assess the oncological impact of this scoring system.</p> </sec> <sec id="codi12682-sec-0002" sec-type="section"> <title>Method</title> <p>The project was a retrospective cohort study over a 10‐year period. Two hundred and two patients with rectal cancer who had received CRT followed by curative surgery were included. A histopathologist prospectively scored each specimen and the impact of the scoring system on survival and recurrence was analysed.</p> </sec> <sec id="codi12682-sec-0003" sec-type="section"> <title>Results</title> <p>One hundred and ninety patients completed long‐course preoperative CRT and formed the basis of the study. Overall, 40 recurrences (local and distant) were observed over a median follow‐up of 36 months. The lymph node regression score was a significant predictor of tumour recurrence (hazard ratio 1.273, 95% CI 1.048–1.548; <italic>P </italic>=<italic> </italic>0.015). The overall mortality rate was 21%, and a lower lymph node regression score was correlated with an improved survival curve (<italic>P </italic>=<italic> </italic>0.01).</p> </sec> <sec id="codi12682-sec-0004" sec-type="section"> <title>Conclusion</title> <p>The results demonstrate that lymph node response to neoadjuvant CRT based on a nodal regression scoring system is related to recurrence.</p> </sec> </abstract>