Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract · 2026
The impact of lymph node harvest on recurrence in rectal cancer after neoadjuvant chemoradiotherapy.
СтатьяНазвание и аннотация: Перевод пока не подготовлен
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Jo Min Hyeong, Kim Duck-Woo, Lee Ji Ae, Choi Mi Jeong, Shin Hye-Rim, Lee Tae-Gyun, Ahn Hong-Min, Oh Heung-Kwon, Kang Sung-Bum, Kim Min Jung, Park Ji Won, Ryoo Seung-Bum, Jeong Seung-Yong, Park Kyu Joo
Аннотация
BACKGROUND: Although current guidelines recommend harvesting ≥12 lymph nodes (LNs) for rectal cancer staging, its appropriateness after neoadjuvant chemoradiotherapy (nCRT) remains debated. This study evaluated the prognostic value of harvested LNs (HLNs) after nCRT.
METHODS: We retrospectively analyzed 1596 patients who underwent radical surgery for rectal cancer after nCRT at 2 tertiary hospitals between April 2004 and December 2021. Patients were categorized by the number of HLNs (≥12 vs <12). Clinicopathologic outcomes and recurrence were compared, and multivariable analyses were performed to identify factors associated with recurrence and survival.
RESULTS: Less than 12 HLNs were found in 321 patients (20.1%), and ≥12 in 1275 (79.9%). No significant differences were observed in age, sex, tumor height, resection margins, or circumferential resection margin involvement. The ≥12 HLNs group showed more advanced ypT, ypN, and overall stage, with higher rates of venous and perineural invasion. Completeness of postoperative chemotherapy was comparable. However, the <12 HLNs group demonstrated a higher recurrence rate (24.6% vs 18.8%; P = .026). In multivariate analysis, <12 HLNs were identified as independent risk factors for overall survival (OS) (hazard ratio [HR], 1.624; P = .002) and disease-free survival (HR, 1.297; P = .047). Kaplan-Meier analysis showed 5-year OS was significantly lower in the <12 HLNs group than the ≥12 HLNs group (83.1% vs 86.1%; P = .003).
CONCLUSION: Harvesting fewer than 12 LNs was significantly associated with worse OS and remains an independent prognostic factor of rectal cancer after nCRT.
METHODS: We retrospectively analyzed 1596 patients who underwent radical surgery for rectal cancer after nCRT at 2 tertiary hospitals between April 2004 and December 2021. Patients were categorized by the number of HLNs (≥12 vs <12). Clinicopathologic outcomes and recurrence were compared, and multivariable analyses were performed to identify factors associated with recurrence and survival.
RESULTS: Less than 12 HLNs were found in 321 patients (20.1%), and ≥12 in 1275 (79.9%). No significant differences were observed in age, sex, tumor height, resection margins, or circumferential resection margin involvement. The ≥12 HLNs group showed more advanced ypT, ypN, and overall stage, with higher rates of venous and perineural invasion. Completeness of postoperative chemotherapy was comparable. However, the <12 HLNs group demonstrated a higher recurrence rate (24.6% vs 18.8%; P = .026). In multivariate analysis, <12 HLNs were identified as independent risk factors for overall survival (OS) (hazard ratio [HR], 1.624; P = .002) and disease-free survival (HR, 1.297; P = .047). Kaplan-Meier analysis showed 5-year OS was significantly lower in the <12 HLNs group than the ≥12 HLNs group (83.1% vs 86.1%; P = .003).
CONCLUSION: Harvesting fewer than 12 LNs was significantly associated with worse OS and remains an independent prognostic factor of rectal cancer after nCRT.