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The effect of pericolic lymph nodes metastasis beyond 10?cm proximal to the tumor on patients with rectal cancer.

ABSTRACT: BACKGROUND:This study aims to determine the real incidence of pericolic lymph nodes metastasis beyond 10?cm proximal to the tumor (pPCN) and its prognostic significance in rectal cancer patients. METHODS:Consecutive patients with rectal cancer underwent curative resection between 2015 and 2017 were included. Margin distance was marked and measured in vivo and lymph nodes were harvested on fresh specimens. Clinicopathological characteristics and oncological outcomes (3-year overall survival (OS) and disease-free survival (DFS)) were analyzed between patients with pPCN and patients without pPCN (nPCN). RESULTS:There were 298 patients in the nPCN group and 14 patients (4.5%) in pPCN group. Baseline characteristics were balanced except more patients received preoperative or postoperative chemoradiotherapy in pPCN group. Preoperative more advanced cTNM stage (log-rank p?=?0.005) and intraoperative more pericolic lymph nodes beyond 10?cm proximal to the tumor (PCNs) (log-rank p?=?0.002) were independent risk factors for pPCN. The maximum short-axis diameter of mesenteric lymph nodes ?8?mm was also contributed to predicting the pPCN. pPCN was an independent prognostic indicator and associated with worse 3-year OS (66% vs 91%, Cox p?=?0.033) and DFS (58% vs 92%, Cox p?=?0.012). CONCLUSION:The incidence of pPCN was higher than expected. Patients with high-risk factors (cTNM stage III or more PCNs) might get benefits from an extended proximal bowel resection to avoid residual positive PCNs.

SUBMITTER: Yang X

PROVIDER: S-EPMC7304140 | biostudies-literature | 2020 Jun

REPOSITORIES: biostudies-literature

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The effect of pericolic lymph nodes metastasis beyond 10 cm proximal to the tumor on patients with rectal cancer.

Yang Xuyang X Zheng Erliang E Ye Lina L Gu Chaoyang C Hu Tao T Jiang Dan D He Du D Wu Bing B Wu Qinbing Q Yang Tinghan T Wei Mingtian M Meng Wenjian W Deng Xiangbing X Wang Ziqiang Z Zhou Zongguang Z

BMC cancer 20200619 1

<h4>Background</h4>This study aims to determine the real incidence of pericolic lymph nodes metastasis beyond 10 cm proximal to the tumor (pPCN) and its prognostic significance in rectal cancer patients.<h4>Methods</h4>Consecutive patients with rectal cancer underwent curative resection between 2015 and 2017 were included. Margin distance was marked and measured in vivo and lymph nodes were harvested on fresh specimens. Clinicopathological characteristics and oncological outcomes (3-year overall ...[more]

PMID: 32560635

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Project description:BackgroundSentinel lymph node biopsy (SLNB) is the standard axillary staging approach for early breast cancer with clinically negative axillary involvement. Adequate SLNB should include the removal of not only radioactive tracer-labeled lymph nodes (hot nodes or SLNs) but also suspicious unlabeled nodes (non-hot nodes or non-SLNs). However, the biopsy of non-hot nodes is highly dependent on the surgeons' experiences. This article aims to facilitate the surgeon's decision making by elucidating parameters that correlate with non-hot node metastasis.MethodsFrom 2013 to 2016, clinically node-negative (cN0) breast cancer patients receiving axillary SLNB using single Tc-99m tracer method at our institute were recruited. Patients were excluded if they had received prior neoadjuvant chemotherapy. Among them, cases that have at least one non-isotope-hot node biopsied were retrospectively reviewed with a particular focus on patients with pathologically negative isotope-hot SLNs. The correlation of clinicopathological data with metastasis to axillary lymph nodes and sentinel lymph nodes was analyzed with the Chi-squared test, Fisher's exact test, and multivariate logistic regression. Receiver operating curve (ROC) was applied for continuous variables that predicted non-hot node metastasis; relapse-free survival (RFS) and locoregional relapse-free survival (LRRFS) were compared by Kaplan-Meier analysis.ResultsIn 632 isotope-hot SLN negative patients, T stage showed a correlation with non-isotope-hot SLN metastasis (p = 0.035, odds ratio (OR) 9.65). Tumors larger than 2.5 cm best predict non-isotope-hot SLN metastasis (area under curve (AUC) = 0.71). With a median follow up of 41.80 months, locoregional relapse-free survival was significantly worse in cases with non-hot node metastasis (66.2% vs. 69.0%, p = 0.001).ConclusionIn the setting of SLNB using single radioisotope tracer, non-hot node metastasis in cases with negative hot SLN still carries a higher locoregional recurrence rate (13.3%). For early breast cancer larger than 2.5 cm, removal of suspicious non-hot nodes should be included for a precision therapy.

Dataset Information

The effect of pericolic lymph nodes metastasis beyond 10?cm proximal to the tumor on patients with rectal cancer.

Publications

The effect of pericolic lymph nodes metastasis beyond 10 cm proximal to the tumor on patients with rectal cancer.

Similar Datasets

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