Reduction in the size of enlarged pelvic lymph nodes after chemoradiation therapy is associated with fewer lymph node metastases in locally advanced rectal carcinoma

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• 作者：Mitsuaki Morimoto ; Yasuyuki Miyakura ; Alan T. Lefor ; Kazuya Takahashi…
• 关键词：Rectal cancer ; CRT ; Lateral lymph node ; Lateral lymph node dissection
• 刊名：Surgery Today
• 出版年：2015
• 出版时间：July 2015
• 年：2015
• 卷：45
• 期：7
• 页码：834-840
• 全文大小：847 KB
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  14.Onaitis MW, Noone RB, Hartwig M, Hurwitz H, Morse M, Jowell P, et al. Neoadjuvant chemoradiation for rectal cancer: analysis of clinical outcomes from a 13-year institutional experience. Ann Surg. 2001;233:778-5.PubMed Central PubMed View Article
  15.Kim NK, Baik SH, Seong JS, Kim H, Roh JK, Lee KY, et al. Oncologic outcomes after neoadjuvant chemoradiation followed by curative resection with tumor-specific mesorectal excision for fixed locally advanced rectal cancer: impact of postirradiated pathologic downstaging on local recurrence and survival. Ann Surg. 2006;244:1024-0.PubMed Central PubMed View Article
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• 作者单位：Mitsuaki Morimoto (1)
  Yasuyuki Miyakura (1)
  Alan T. Lefor (1)
  Kazuya Takahashi (1)
  Hisanaga Horie (1)
  Koji Koinuma (1)
  Hiroyuki Tanaka (1)
  Homare Ito (1)
  Tetsuichiro Shimizu (1)
  Yoshihiko Kono (1)
  Naohiro Sata (1)
  Noriyoshi Fukushima (2)
  Takashi Sakatani (2)
  Yoshikazu Yasuda (1)
  
  1. Department of Surgery, Jichi Medical University, 3311-1 Yakushiji, Shimotsuke, Tochigi, 329-0498, Japan
  2. Department of Pathology, Jichi Medical University, 3311-1 Yakushiji, Shimotsuke, Tochigi, 329-0498, Japan
  
• 刊物类别：Medicine
• 刊物主题：Medicine & Public Health
  Surgery
  Abdominal Surgery
  Thoracic Surgery
  Vascular Surgery
  Cardiac Surgery
  Surgical Oncology
  
• 出版者：Springer Japan
• ISSN：1436-2813

文摘

Purpose We hypothesized that a reduction in the size of the lymph nodes after neoadjuvant therapy for locally advanced rectal carcinoma would be associated with decreased lymph node metastases and/or a better prognosis. Methods Between March 2006 and April 2012, 71 patients with primary rectal cancer received neoadjuvant chemoradiation therapy (CRT). For all lymph nodes 5?mm or larger in size, the major and minor axes were measured on CT scan images, and the product was calculated. The lymph node size was determined before and after CRT. The patients were divided into three groups based on the lymph node size before and after treatment. Group A exhibited a reduction in size of 60?% or more, Group B a reduction of less than 60?% and Group C had no lymph node enlargement before treatment. Results The incidence of lymph node metastases on pathological examination was 15?% in Group A and 50?% in Group B (p?=?0.006). The five-year disease-free survival in Group A was 84?% compared with 78?% in Group B (log rank p?=?0.34). The five-year overall survival in Group A was 92?% compared with 74?% in Group B (log rank p?=?0.088). Conclusions A reduction in the size of enlarged lymph nodes after neoadjuvant therapy may be a useful prognostic factor for recurrence and survival.