User: Guest  Login
Title:

Reduced lymph node yield in rectal carcinoma specimen after neoadjuvant radiochemotherapy has no prognostic relevance.

Document type:
Journal Article; Article
Author(s):
Doll, D; Gertler, R; Maak, M; Friederichs, J; Becker, K; Geinitz, H; Kriner, M; Nekarda, H; Siewert, JR; Rosenberg, R
Abstract:
BACKGROUND: In colorectal surgery UICC/AJCC criteria require a yield of 12 or more locoregional lymph nodes for adequate staging. Neoadjuvant radiochemotherapy for rectal carcinoma reduces the number of lymph nodes in the resection specimen; the prognostic impact of this reduced lymph node yield has not been determined. METHODS: One hundred two patients with uT3 rectal carcinoma who were receiving neoadjuvant radiochemotherapy were compared with 114 patients with uT3 rectal carcinoma who were receiving primary surgery followed by adjuvant radiochemotherapy. Total lymph node yield and number of tumor-positive lymph nodes were determined and correlated with survival. RESULTS: After neoadjuvant radiochemotherapy both total lymph node yield (12.9 vs. 21.4, p < 0.0001) and number of tumor-positive lymph nodes (1.0 vs. 2.3, p = 0.014) were significantly lower than after primary surgery plus adjuvant radiochemotherapy. Reduced total lymph node yield in neoadjuvantly treated patients had no prognostic impact, with overall survival of patients with 12 or more lymph nodes the same as that of patients with less than 12 lymph nodes. Overall survival of neoadjuvantly treated patients was significantly influenced by the number of tumor-positive lymph nodes with 5-year-survival rates of 88, 63, and 39% for 0, 1-3, and more than 3 positive lymph nodes (p < 0.0001). CONCLUSION: The UICC/AJCC criterion of a total lymph node yield of 12 or more should be revised for rectal carcinoma patients.
Journal title abbreviation:
World J Surg
Year:
2009
Journal volume:
33
Journal issue:
2
Pages contribution:
340-7
Language:
eng
Fulltext / DOI:
doi:10.1007/s00268-008-9838-8
Pubmed ID:
http://view.ncbi.nlm.nih.gov/pubmed/19034566
Print-ISSN:
0364-2313
TUM Institution:
Chirurgische Klinik und Poliklinik; Institut für Allgemeine Pathologie und Pathologische Anatomie; Klinik und Poliklinik für RadioOnkologie und Strahlentherapie
 BibTeX