Prognostic importance of lymph node count and ratio in rectal cancer after neoadjuvant chemoradiotherapy: Results from a cross-sectional study

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Abstract

BACKGROUND: The aim of this study was to determine the prognostic value of lymph node count (LNC) and lymph node ratio (LNR) in rectal cancer after neoadjuvant chemoradiotherapy (CRT).

METHODS: Patients who underwent neoadjuvant CRT and total mesorectal excision (TME) for Stage I-III rectal cancer were selected from a cross-sectional study including 71 Dutch centres. Primary outcome parameters were disease-free survival (DFS) and overall survival (OS). Prognostic significance of LNC and LNR (cut-off values 0.15, 0.20, 0.30) was tested for different (sub)groups.

RESULTS: From 2095 registered patients, 458 were included, of which 240 patients with LNC < 12 and 218 patients with LNC ≥ 12. LNC was not significantly associated with DFS (p = 0.35) and OS (p = 0.59). In univariable analysis, LNR was significantly associated with DFS and OS in the whole cohort and LNC subgroups, but not in multivariable analysis.

CONCLUSIONS: LNC was not associated with long-term oncological outcome in rectal cancer patients treated with CRT, nor was LNR when corrected for N-stage. However, LNR might be used to identify subgroups of node-positive patients with a favourable outcome.

Original languageEnglish
Pages (from-to)367-377
Number of pages11
JournalJournal of Surgical Oncology
Volume124
Issue number3
DOIs
Publication statusPublished - 1 Sept 2021

Keywords

  • chemoradiotherapy
  • disease-free survival
  • lymph nodes
  • rectal cancer
  • survival
  • Multivariate Analysis
  • Prognosis
  • Cross-Sectional Studies
  • Humans
  • Survival Rate
  • Lymphatic Metastasis
  • Disease-Free Survival
  • Lymph Nodes/pathology
  • Neoadjuvant Therapy
  • Retrospective Studies
  • Neoplasm Staging
  • Netherlands/epidemiology
  • Rectal Neoplasms/mortality

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