American journal of surgery · 2025
Risk factors for lymph node metastasis in p/ypT1-2 rectal cancer.
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Choi Young Hae, Huh Jung Wook, Lee Woo Yong, Yun Seong Hyeon, Kim Hee Cheol, Cho Yong Beom, Park Yoonah, Shin Jung Kyong
Аннотация
BACKGROUND: This study aimed to identify and compare risk factors for lymph node metastasis in rectal cancer patients with and without neoadjuvant chemoradiotherapy.
METHODS: We retrospectively analyzed 1354 patients who underwent curative surgery, categorized into a Non-CRT group (pT1-2, n = 921) and a CRT group (ypT1-2, n = 433).
RESULTS: Lymph node metastasis occurred in 20.4 % of Non-CRT and 17.6 % of CRT patients. Independent predictors were lymphatic invasion (p < 0.001), tumor budding (p < 0.001), and pT2 stage (p = 0.002) in Non-CRT, and lymphatic invasion (p = 0.001) and venous invasion (p < 0.001) in CRT. Venous invasion showed a markedly stronger association in the CRT group (OR 12.102). Lymph node metastasis rates increased up to 64.3 % and 87.5 % with all risk factors, respectively.
CONCLUSION: Risk factors for lymph node metastasis differed by CRT status, with venous invasion emerging as the key determinant in the CRT group.
METHODS: We retrospectively analyzed 1354 patients who underwent curative surgery, categorized into a Non-CRT group (pT1-2, n = 921) and a CRT group (ypT1-2, n = 433).
RESULTS: Lymph node metastasis occurred in 20.4 % of Non-CRT and 17.6 % of CRT patients. Independent predictors were lymphatic invasion (p < 0.001), tumor budding (p < 0.001), and pT2 stage (p = 0.002) in Non-CRT, and lymphatic invasion (p = 0.001) and venous invasion (p < 0.001) in CRT. Venous invasion showed a markedly stronger association in the CRT group (OR 12.102). Lymph node metastasis rates increased up to 64.3 % and 87.5 % with all risk factors, respectively.
CONCLUSION: Risk factors for lymph node metastasis differed by CRT status, with venous invasion emerging as the key determinant in the CRT group.