Impact of the viability assessment of lateral lymph node metastasis in rectal cancer after neoadjuvant chemoradiotherapy
Impact of the viability assessment of lateral lymph node metastasis in rectal cancer after neoadjuvant chemoradiotherapy
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直肠癌新辅助放化疗后侧方淋巴结转移活力评估的影响
DOI：
10.1007/s00384-021-04085-4
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发表时间：
2022
影响因子：
2.8
通讯作者：
Ishihara Soichiro
中科院分区：
文献类型：
--
作者：
Ozaki Kosuke;Kawai Kazushige;Nozawa Hiroaki;Sasaki Kazuhito;Murono Koji;Emoto Shigenobu;Abe Hiroyuki;Ushiku Tetsuo;Ishihara Soichiro
目的术前放化疗（CRT）后行全直肠系膜切除（TME）不清扫侧方淋巴结（LLN）是治疗低位进展期直肠癌的常用方法。然而，目前还不清楚是否残留的癌细胞在LLNs进行凋亡，消失，或再生，如果unestected.MethodsOverall，293例连续T3/4直肠癌谁接受CRT根治性手术之间2003年9月和2018年12月进行了回顾性分析。我们使用M30 cytoDEATH免疫染色评估了残留原发肿瘤、直肠系膜淋巴结（MLN）和LLN的凋亡，并评估了凋亡程度。侧淋巴结转移阳性（LLNM +）和侧淋巴结转移阴性（LLNM-）groups.ResultsThere的预后差异被诊断为一个完全缓解苏木精和伊红（HE）染色31例（10.6%）。残留癌细胞在28例患者的原发性病变中显示完全凋亡，仅2例患者的转移性MLN中，1例患者的转移性LLN中。LLNM +组有一个显着较差的远处复发，复发的生存率，总生存率比LLNM- group.ConclusionThe大部分的残留癌组织中观察到的淋巴结HE染色被发现是非凋亡。如果治疗前影像学检查怀疑LLN转移，则应考虑行LLN清扫和TME。
PurposePreoperative chemoradiotherapy (CRT) followed by total mesorectal excision (TME) without lateral lymph node (LLN) dissection is widely performed for lower advanced rectal cancer. However, it is unclear whether residual cancer cells in the LLNs undergo apoptosis, disappear, or regrow if unresected.MethodsOverall, 293 consecutive patients with T3/4 rectal cancer who underwent CRT followed by radical surgery between September 2003 and December 2018 were retrospectively reviewed. We assessed apoptosis of the residual primary tumor, mesorectum lymph nodes (MLN), and LLN using M30 cytoDEATH immunostaining and evaluated the degree of apoptosis. The difference in the prognosis of the lateral lymph node metastasis positive (LLNM +) and lateral lymph node metastasis negative (LLNM-) groups was assessed.ResultsThere were 31 patients (10.6%) who were diagnosed with a complete response by hematoxylin and eosin (HE) staining. The residual cancer cells showed complete apoptosis in the primary lesion in 28 patients, in the metastatic MLN in only two patients, and in the metastatic LLN in one patient. The LLNM + group had a significantly poorer distant recurrence, recurrence-free survival, and overall survival than the LLNM- group.ConclusionThe majority of the residual cancer tissue in LNs observed by HE staining was found to be non-apoptotic. If LLN metastasis is suspected on pretreatment imaging, performing LLN dissection together with TME should be considered.
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DOI：
10.6004/jnccn.2018.0061
发表时间：
2018-07
期刊：
Journal of the National Comprehensive Cancer Network : JNCCN
影响因子：
--
作者：
Benson AB;Venook AP;Al-Hawary MM;Cederquist L;Chen YJ;Ciombor KK;Cohen S;Cooper HS;Deming D;Engstrom PF;Grem JL;Grothey A;Hochster HS;Hoffe S;Hunt S;Kamel A;Kirilcuk N;Krishnamurthi S;Messersmith WA;Meyerhardt J;Mulcahy MF;Murphy JD;Nurkin S;Saltz L;Sharma S;Shibata D;Skibber JM;Sofocleous CT;Stoffel EM;Stotsky-Himelfarb E;Willett CG;Wuthrick E;Gregory KM;Gurski L;Freedman-Cass DA
通讯作者：
Freedman-Cass DA
影响因子：
3.9
作者：
Kawai, Kazushige;Shiratori, Hiroshi;Ishihara, Soichiro
通讯作者：
Ishihara, Soichiro
结直肠癌壁外静脉侵犯的发生率：新技术的发现。
影响因子：
3.3
作者：
K. Dirschmid;Alois Lang;G. Mathis;A. Haid;M. Hansen
通讯作者：
M. Hansen
影响因子：
3.9
作者：
Nagawa, H;Muto, T;Sawada, T
通讯作者：
Sawada, T
影响因子：
3
作者：
HOJO, K;KOYAMA, Y;MORIYA, Y
通讯作者：
MORIYA, Y