Patterns of neoplastic foci and lymph node micrometastasis within the mesorectum

Wang, Cun; Zhou, Zong‐Guang; Wang, Zhao; Zheng, Yuanshui; Zhao, Gao-ping; Yu, Yanyan; Cheng, Zhong; Chen, Daiyun; Liu, Weiping

doi:10.1007/s00423-005-0562-7

Cited by 70 publications

(47 citation statements)

References 23 publications

(23 reference statements)

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“…5 mm in diameter are more often involved by the tumor than bigger ones. Such findings pinpoint the importance of TME [24][25][26] . The pathologist must differentiate the peritonealized from non-peritonealized surfaces of the resection.…”

Section: Circumferential Resection Marginmentioning

confidence: 70%

Role of Total Mesorectal Excision and of Circumferential Resection Margin in Local Recurrence and Survival of Patients with Rectal Carcinoma

Tzardi¹

2007

Dig Dis

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Rectal cancer is a common disease with poor prognosis because of local recurrence and metastases. Local recurrence arises mainly as a result of incomplete surgical resection. Evaluation of completeness of the mesorectum provides significant information about prognosis. Total mesorectal excision (TME) has become the surgical treatment of choice for rectal cancer because adopting the principles of TME achieves very low local recurrence rates. The adoption of the TME principles along with the estimation of the circumferential resection margin on the non-peritonealized surface of the resected rectal specimen are the most important predictors of local recurrence.

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Section: Circumferential Resection Marginmentioning

confidence: 70%

Role of Total Mesorectal Excision and of Circumferential Resection Margin in Local Recurrence and Survival of Patients with Rectal Carcinoma

Tzardi¹

2007

Dig Dis

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“…A small T1 tumor has a 15% risk of lymph node (LN) involvement and T2 a 25% risk of LN involvement, but these nodes are likely to be close to the primary tumor [36]. Current evidence suggests that 90% of involved lymph nodes lie within 2 cm superior to the macroscopic tumor on MRI [75].…”

Section: Discussionmentioning

confidence: 99%

“…In contrast, for cT2 tumors 58/194 (30%) had N1 and 14 (7%) had N2 nodal disease, but only 8/194 (4%) had lymph node metastases beyond the pararectal mesorectum. Descriptions of mapping of sites of lymph nodes within the mesorectum in more advanced stages are sparse and performed on few patients [36].…”

Section: Mesorectal Lymph Nodes In Surgical Seriesmentioning

confidence: 99%

One Size Does Not Fit All: Planning Volumes for Radiotherapy in Rectal Cancer—Should We Tailor Radiotherapy Fields to Stage and Risk?

Dulley

Harrison

Glynne‐Jones

2010

Curr Colorectal Cancer Rep

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The optimal clinical target volume (CTV) in preoperative radiotherapy and chemoradiotherapy for resectable rectal cancer prior to total mesorectal excision (TME) remains poorly defined. TME does not remove all nodal stations potentially harboring subclinical disease. A literature search was employed to identify studies exploring planning volumes in preoperative radiotherapy and chemoradiation schedules. There are few studies of local recurrence after TME mainly relating to short course preoperative radiotherapy (SCPRT), and even fewer to chemoradiotherapy. Lymph nodes and their precise location are well described in Japanese and Korean, but not generally in Western series. We recommend customized CTV delineations based on site and stage according to clinical and MRI staging, with adaptations for high-risk features. Although these proposed CTV delineations have not been evaluated in randomized trials, their use appears rational and based on current evidence.

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“…First, Wang et al reported that many as 94% of involved nodes may be smaller than 5 mm (20) ; thus, although we utilized a cut-off size of 5 mm, metastases of ≤5 mm could not be identi!ied using this technique. CT cut-offs of 2 or 3 mm would presumably result in higher NPV, and thus more strongly to support our observations.…”

Section: "Watchmentioning

confidence: 99%

Optimal timing of computed tomography for assessing lymph nodes after neoadjuvant chemoradiotherapy for rectal cancer

Lai

Liu

et al. 2016

IJRR

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Background: This study assessed the op mal ming of computed tomography for detec on of metasta c disease in locoregional lymph nodes in pa ents with rectal cancer who have undergone chemoradiotherapy. Materials and Methods: This observa onal retrospec ve study was performed in a single ins tu on. All pa ents with locally advanced rectal cancer treated with chemoradiotherapy, followed by a total mesorectum excision from January 1, 2003 to December 31, 2012, were included. Lymph node metastases evident on preopera ve computed tomography were compared with postopera ve pathologic lymph node status. Results: The study popula on consisted of 108 pa ents: Group A (nodal nega ve on preopera ve computed tomography, n = 52) and Group B (nodal posi ve on preopera ve computed tomography, n = 56). Analysis of the computed tomography scans in Group A revealed a high ability (98.07%) to predict nega ve lymph nodes, compared to 58.92% for predic ng posi ve lymph nodes in Group B. Conclusion: The results of this study suggest that the op mal ming of computed tomography for assessing lymph nodes a0er neoadjuvant chemoradiotherapy for rectal cancer is a0er 6 weeks; this ming might be key for predic on of complete clinical responses.

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Patterns of neoplastic foci and lymph node micrometastasis within the mesorectum

Cited by 70 publications

References 23 publications

Role of Total Mesorectal Excision and of Circumferential Resection Margin in Local Recurrence and Survival of Patients with Rectal Carcinoma

Role of Total Mesorectal Excision and of Circumferential Resection Margin in Local Recurrence and Survival of Patients with Rectal Carcinoma

One Size Does Not Fit All: Planning Volumes for Radiotherapy in Rectal Cancer—Should We Tailor Radiotherapy Fields to Stage and Risk?

Optimal timing of computed tomography for assessing lymph nodes after neoadjuvant chemoradiotherapy for rectal cancer

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