2009
DOI: 10.1007/s11605-008-0717-2
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Neoadjuvant Chemoradiation for Rectal Cancer Reduces Lymph Node Harvest in Proctectomy Specimens

Abstract: Standard neoadjuvant therapy significantly decreases the number of lymph nodes retrieved following proctectomy for patients with rectal cancers. Quality initiatives or performance measures evaluating lymph node harvest following proctectomy should reflect the use of preoperative chemoradiation.

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Cited by 61 publications
(48 citation statements)
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“…Even though it has been shown that there is an association between neo-adjuvant treatment and reduced LNY [15,16], we found a significant association between increasing LNY and the probability of detecting N-positive disease up to an LNY of 12-17, irrespective of neo-adjuvant treatment. This result indicates that an LNY of at least 12 LNs is needed to ensure N-negative disease, irrespective of neo-adjuvant treatment, which is in accordance with the abovementioned guidelines.…”
Section: Discussioncontrasting
confidence: 95%
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“…Even though it has been shown that there is an association between neo-adjuvant treatment and reduced LNY [15,16], we found a significant association between increasing LNY and the probability of detecting N-positive disease up to an LNY of 12-17, irrespective of neo-adjuvant treatment. This result indicates that an LNY of at least 12 LNs is needed to ensure N-negative disease, irrespective of neo-adjuvant treatment, which is in accordance with the abovementioned guidelines.…”
Section: Discussioncontrasting
confidence: 95%
“…Of these, 2123 (31.2 %) had received neo-adjuvant treatment. The median LNY was 13 (interquartile range (IQR) [8][9][10][11][12][13][14][15][16][17][18][19]. In the −neo-adjuvant treatment group compared to the +neo-adjuvant treatment group, there were median LNYs of 15 (IQR 10-22) and 10 (IQR 6-15), respectively, (p<0.0001), (Table 1).…”
Section: Patient Characteristicsmentioning
confidence: 99%
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“…This signifies that the tumor grade may predict the response to treatment (Table 2). In 8.3% of our patients there were lymph nodes retrieved in the specimen after surgical resection, this correlates well with the series reported by De laFuente SG et al 20 , who found fewer total lymph-nodes were retrieved in the neoadjuvant therapy patients compared to those who did not receive preoperatively therapy (Neo 14.6 +/-0.6 vs. No-Neo 17.2 +/-1.1).…”
Section: Discussionsupporting
confidence: 92%
“…Furthermore, while a correlation between lymph node metastasis and poor oncologic outcome in patients treated with PCRT and radical resection has been suggested, the value of the LNR after PCRT remains controversial [14,15] . PCRT has been shown to result in a significant decrease in both the size and number of LNs available for examination after resection [16][17][18][19][20] . Consequently, the number of LNs examined could be below the recommended number in patients with rectal cancer.…”
Section: Introductionmentioning
confidence: 99%