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Prognostic importance of lymph node count and ratio in rectal cancer after neoadjuvant chemoradiotherapy: Results from a cross‐sectional study
Author(s) -
Detering Robin,
Meyer Vincent M.,
Borstlap Wernard A.A.,
BeetsTan Regina G.H.,
Marijnen Corrie A.M.,
Hompes Roel,
Tanis Pieter J.,
Westreenen Henderik L.
Publication year - 2021
Publication title -
journal of surgical oncology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.201
H-Index - 111
eISSN - 1096-9098
pISSN - 0022-4790
DOI - 10.1002/jso.26522
Subject(s) - medicine , total mesorectal excision , colorectal cancer , lymph node , chemoradiotherapy , oncology , neoadjuvant therapy , stage (stratigraphy) , overall survival , cancer , gastroenterology , breast cancer , paleontology , biology
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.