Neoadjuvant therapy for rectal cancer decreases the number of lymph nodes harvested in operative specimens

Clinicopathological characteristics predict lymph node metastases in ypT0‐2 rectal cancer after chemoradiotherapy

“…The relatively low number of examined lymph nodes is a limitation to this study, as a minimum of 12 nodes is generally recommended for adequate nodal staging . However, lymph node yield is known to decrease after chemoradiation, and the median number of seven nodes found in this study is comparable with results described in several previous reports after neoadjuvant therapy . Lymph node yield was not associated with nodal positivity in the current population.…”

Increased Lymph Node Yield Is Associated With Improved Survival in Rectal Cancer Irrespective of Neoadjuvant Treatment

“…of these, 2123 patients (31.2%) had neoadjuvant treatment before surgery, and 2665 patients (39.1%) had an lny less than 12. in the whole cohort, the median lny was 13 (interquartile range (iQR), [8][9][10][11][12][13][14][15][16][17][18][19], and in the -neoadjuvant treatment group and the + neoadjuvant treatment group the median lnys were 15 (iQR, 10-22) and 10 (iQR, 6-15; p < 0.0001; table 1). the percentages of patients with an lny less than 12 were 57.7% in the + neoadjuvant treatment group and 30.8% in the -neoadjuvant treatment group (p < 0.0001; table 1).…”

“…it has been demonstrated that the lny differs substantially according to the pt stage and the use of neoadjuvant treatment. 10,17 moreover, the surgeon, the size and organization of the individual hospitals, 16 and even the pathologist 18 have been associated with the lny. Despite these issues with regard to the lny, the association between lny and CRC surgery outcome has been extensively studied mostly in mixed studies of colon and rectal cancer, where an association between low lny and adverse prognostic outcomes, especially for uiCC stage ii and iii disease, [19][20][21][22][23] has been found.…”

Lymph node yield is an independent predictor of survival in rectal cancer regardless of receipt of neoadjuvant therapy

“…The issue of harvesting at least 12 lymph nodes in rectal cancer is debated, particularly in the population of patients that receive neoadjuvant treatment 6 13 30. Previous work has consistently found a significant decrease in the number of lymph nodes harvested in patients with rectal cancer who receive neoadjuvant treatment compared with those who did not 4 6. However, the prognostic value of this finding is controversial 11 31–33.…”