The total number of lymph node metastases is a more significant risk factor for poor prognosis than positive lateral lymph node metastasis

Homma, Yoichiro; Hamano, Takashi; Otsuki, Yoshiro; Shimizu, Satoru; Kobayashi, Yasuyuki

doi:10.1007/s00595-014-0913-5

Cited by 12 publications

(9 citation statements)

References 26 publications

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“…The CLNM was histopathologically con rmed in 251 (33.6%) PTC patients which were consistent with reports by other similar works 13,14,26 . Besides, 58 (7.8%) patients were diagnosed to suffer from LLNM which was consistent with Homma et al study (8.4%) 6 but much lower to the observation result (25.6%) made by Yang et al 26 . This divergence might due to the possibly different study location, population, and number of patients.…”

Section: Discussionsupporting

confidence: 87%

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A Nomogram Predicting Central Lymph Node Metastasis for Patients with Papillary Thyroid Cancer

Min¹,

Feng²,

Xiang³

et al. 2021

Preprint

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PurposeCentral lymph node metastasis (CLNM) has been regarded as a predictor of relatively poor prognosis in patients with papillary thyroid carcinoma (PTC). Our study aimed to identify the risk factors for CLNM and develop a nomogram helping clinical decisions.MethodA total of 1,054 patients underwent thyroidectomy between January 2019 and September 2020 in the Second Affiliated Hospital of Chongqing Medical University. Among these patients, 747 patients with histopathologically confirmed PTC were included in this retrospective study. The perioperative clinical data of these patients were reviewed and analyzed. Univariate and multivariate logistic regression were used to analyze the correlation between clinicopathological characteristics and CLNM. A nomogram model was subsequently established and validated by a decision curve analysis (DCA) curve.Result33.6% (251/747) patients with PTC were confirmed with CLNM. And the CLNM was determined in 31.4% (168/535) non- Hashimoto’s thyroiditis (HT) patients and 39.2% (83/212) HT patients, respectively. 4 clinicopathological factors including gender, age, size, and HT were confirmed significantly associated with CLNM. The established nomogram showed promising discrimination and consistency in the study group with a C-index of 0.703. The decision curve analysis showed the nomogram has clinical feasibility.ConclusionOur data suggested that male gender, younger age, larger tumor size, and HT condition played a pivotal role in promoting the CLNM of PTC patients. And the nomogram we developed can help surgeons make the individualized clinical decision in PTC patients during preoperative and interoperative management.

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Section: Discussionsupporting

confidence: 87%

“…Despite a favorable long-term prognosis 4,5 , a minority of patients with central lymph node metastasis (CLNM) and even lateral lymph node metastasis (LLNM) showed relatively poor prognosis 6 . Currently, great achievements have been made in a range of works in determining the risk factors in the progression of PTC [7][8][9] .…”

Section: Introductionmentioning

confidence: 99%

A Nomogram Predicting Central Lymph Node Metastasis for Patients with Papillary Thyroid Cancer

Min¹,

Feng²,

Xiang³

et al. 2021

Preprint

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“…The lateral lymph node metastasis (LPNM) pathway of middle and low rectal cancer was rst proposed by Gerota in 1895 [1] , and the anatomical theoretical system of lateral pelvic lymphatic drainage of rectal cancer gradually formed in the 1950s [2] . LPNM has been reported in approximately 16-23% of patients with middle to low rectal cancer [3] , and it is an important predictive factor for local recurrence and long-term survival [4,5] . Lateral pelvic lymph node dissection (LPND), as a potential radical surgery, is still controversial worldwide.…”

Section: Introductionmentioning

confidence: 99%

Prognostic Significance of Lateral Pelvic Lymph Node Dissection for Middle-Low Rectal Cancer Patients with Lateral Pelvic Lymph Node Metastasis: A Propensity Score Matching Study

Zhou

Jiang

Pei

et al. 2021

Preprint

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BackgroundThere is still controversy regarding whether the addition of lateral pelvic lymph node dissection (LPND) to total mesorectal excision (TME) confers survival benefits to rectal cancer patients with clinical lateral pelvic node metastasis (LPNM). MethodsPatients who underwent TME+LPND were systematically reviewed and divided into the LPNM group (n=29) and the non-LPNM group (n=112). The LPNM group were further subdivided into a high-risk LPNM group (n=14) and a low-risk LPNM group (n=15). Propensity score matching (PSM) was performed to minimize selection bias.ResultsOf the 141 patients undergoing LPND, the local recurrence rate of patients with LPNM was significantly higher than that of patients without LPNM both before (27.6% vs. 4.5%, P=0.001) and after (27.6% vs 3.4%, P=0.025) PSM. Multivariate analysis revealed that LPNM was an independent risk factor for not only OS (HR: 3.06; 95% CI, 1.15–8.17; P=0.025) but also DFS (HR: 2.39; 95% CI, 1.18–4.87; P=0.016) in patients with LPNM after TME+LPND. When the LPNM group was further subdivided, multivariate logistic regression analysis showed that OS and DFS were significantly better in the low-risk group (obturator/internal iliac artery region and < 2 positive LPNs).ConclusionEven after LPND, LPNM patients have a high local recurrence rate and poor prognosis. Moreover, LPNM is an independent poor prognostic factor affecting OS and DFS after TME+LPND. However, LPND appears to confer survival benefits to specific patients with single LPN involvement in the obturator region or internal iliac vessel region.

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“…Lateral pelvic node metastasis (LPNM) has been observed in about 16.7% of cases of middle–low rectal cancer . Studies show that LPNM in rectal cancer is often associated with disease progression and affects prognosis .…”

Section: Introductionmentioning

confidence: 99%

Evaluating predictive factors for determining the presence of lateral pelvic node metastasis in rectal cancer patients following neoadjuvant chemoradiotherapy

Wang

Zhou

et al. 2019

Colorectal Disease

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Aim The need or otherwise for lateral pelvic node dissection (LPND) in rectal cancer patients with clinical lateral pelvic node metastasis (LPNM) after neoadjuvant chemoradiotherapy (nCRT) is controversial. This study was designed to explore the predictive factors for pathological LPNM in rectal cancer patients with clinical LPNM after nCRT.Method From January 2010 to February 2018, a consecutive series of patients with rectal cancer and clinical LPNM after nCRT who underwent total mesorectal excision and LPND were reviewed. Patient demographics, operative and pathological outcomes were collected and analysed.Results A total of 76 consecutive cases were included in this study: 53 (69.7%) patients underwent unilateral LPND and 23 (30.3%) bilateral LPND. The pathological results showed that LPNM was found in 13 (17.1%) patients. Multivariate logistic regression analysis showed that the post-nCRT lateral pelvic node size ≥ 5 mm (OR = 7.67, 95% CI = 1.45-40.63, P = 0.017) and mucinous/signet-ring adenocarcinoma (OR = 4.60, 95% CI = 1.11-19.08, P = 0.035) were independent risk factors for pathological LPNM.Conclusion Post-nCRT lateral pelvic node size ≥ 5 mm and mucinous/signet-ring adenocarcinoma were independent predictive factors of pathological LPNM for rectal cancer patients with clinical LPNM after nCRT, and patients with these characteristics may benefit from LPND.What does this paper add to the literature? The aim of this paper was to determine the optimal indication for lateral pelvic node dissection after neoadjuvant chemoradiotherapy for mid/low rectal cancer, so as to avoid the occurrence of overtreatment in clinical work.

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The total number of lymph node metastases is a more significant risk factor for poor prognosis than positive lateral lymph node metastasis

Abstract: The presence of one or two LLN metastases in patients who have undergone LLN dissection with surgery for lower rectal cancer is not associated with poor prognosis. The number of LLN metastases is a more significant risk factor for poor prognosis.

Cited by 12 publications

References 26 publications

A Nomogram Predicting Central Lymph Node Metastasis for Patients with Papillary Thyroid Cancer

A Nomogram Predicting Central Lymph Node Metastasis for Patients with Papillary Thyroid Cancer

Prognostic Significance of Lateral Pelvic Lymph Node Dissection for Middle-Low Rectal Cancer Patients with Lateral Pelvic Lymph Node Metastasis: A Propensity Score Matching Study

Evaluating predictive factors for determining the presence of lateral pelvic node metastasis in rectal cancer patients following neoadjuvant chemoradiotherapy

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