The Prognostic Impact of the Number of Lymph Nodes Retrieved After Neoadjuvant Chemoradiotherapy With Mesorectal Excision for Rectal Cancer
The Prognostic Impact of the Number of Lymph Nodes Retrieved After Neoadjuvant Chemoradiotherapy With Mesorectal Excision for Rectal Cancer
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DOI：
10.1002/jso.21299
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发表时间：
2009-07-01
影响因子：
2.5
通讯作者：
Ahn, Jung-Bai
中科院分区：
文献类型：
--
作者：
Kim, Young-Wan;Kim, Nam-Kyu;Ahn, Jung-Bai
背景：我们的目的是评估直肠癌根治手术新辅助放化疗患者取回的淋巴结数目及其对淋巴结数目的影响的相关因素。结果：258例患者中，9例无淋巴结(YpNx)，150例淋巴结阴性(ypN(-))，99例淋巴结阳性(ypN(+))。较高的YPT分类(ypT3，4)和较大的肿瘤(>；4切开)与取回的结节数增加相关。治疗前C l：A水平(-gt；5 ng/ml)和ypN(+)分级是影响肿瘤特异性和无复发生存的重要危险因素。结论：在新辅助治疗方案中，ypN(+)疾病是影响肿瘤预后的独立危险因素。结节缺失并不代表肿瘤预后较差。结节的数量并不影响PYN(-)患者的存活率和复发。J·奥科尔外科医生。2009年；100：1-7。(C)2009年Wiley-Liss，Inc.
Background: We aimed to assess factors associated with the number of nodes retrieved and the impact of the number of lymph nodes in rectal cancer patients who underwent neoadjuvant chemoradiation with radical Surgery.Methods: A total of 258 patients were enrolled. Lymph nodes were retrieved from specimens using a manual dissection technique.Results: 017 the 258 patients, nine patients had,in absence of lymph nodes (ypNx), 150 patients had a node-negative Status (ypN(-)) and 99 patients had node-positive disease (ypN(+)). An advanced ypT classification (ypT3,4) and larger tumor (>4 cut) were associated with in increased number of nodes retrieved. The pretreatment Cl:A level (>5 ng/ml) and ypN(+) classification were significant risk factors for cancer specific and recurrence free Survival. There was no significant difference of oncological outcomes among ypNx patients and a subset of ypN(-) patients based oil the number of nodes retrieved using three cutoff values (1-11, 12-25, and 25-65 nodes).Conclusions: In a neoadjuvant setting, ypN(+) disease was in independent risk factor for oncological outcomes. An absence of nodes does not represent an inferior oncological outcome. The number of nodes does not seen to impact survival and recurrence in ypN(-) patients. J. Surg. Oncol. 2009; 100: 1-7. (C) 2009 Wiley-Liss, Inc.