The prognostic impact of the number of lymph nodes retrieved after neoadjuvant chemoradiotherapy with mesorectal excision for rectal cancer

Kim, Young-Wan; Kim, Nam-Kyu; Min, Byung-Soh; Lee, Kang-Young; Sohn, Seonghyang; Cho, Chang-Hwan; Kim, Hoguen; Keum, Ki Chang; Ahn, Joong Bae

doi:10.1002/jso.21299

Cited by 36 publications

(27 citation statements)

References 36 publications

(35 reference statements)

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“…After manual dissection, the absence of LNs (ypNx) was related to favorable prognosis similar to the outcome of node-negative patient (ypN) cases. 20 FIGURE 5. Effect of AC on LN size.…”

Section: Discussionmentioning

confidence: 99%

Optimal Lymph Node Harvest in Rectal Cancer (UICC Stages II and III) after Preoperative 5-FU–based Radiochemotherapy. Acetone Compression is a New and Highly Efficient Method

Gehoff¹,

Basten²,

Sprenger³

et al. 2012

American Journal of Surgical Pathology

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“…After manual dissection, the absence of LNs (ypNx) was related to favorable prognosis similar to the outcome of node-negative patient (ypN) cases. 20 FIGURE 5. Effect of AC on LN size.…”

Section: Discussionmentioning

confidence: 99%

Optimal Lymph Node Harvest in Rectal Cancer (UICC Stages II and III) after Preoperative 5-FU–based Radiochemotherapy. Acetone Compression is a New and Highly Efficient Method

Gehoff¹,

Basten²,

Sprenger³

et al. 2012

American Journal of Surgical Pathology

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“…The mean number of harvested lateral pelvic lymph nodes was more in the laparoscopic group than in the open group (19.5 vs. 15.8, P < 0.05). In lateral pelvic lymph node dissection following neo-adjuvant chemo-radiotherapy, lymph node yield would be low [63] and studies have shown that the number of lymph nodes does not affect the recurrence rate and survival [64] . Furuhata et al [65] confirmed the good oncological outcomes with perioperative morbidity of 16.7% as three patients developed grade 2 urinary retention.…”

Section: Lateral Pelvic Lymph Node Dissectionmentioning

confidence: 99%

Minimal invasive approach for beyond total mesorectal excision/extended resections in rectal cancer

Kumar¹,

Kammar²,

Saklani³

2018

MIS

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Minimal invasive surgery (MIS) is an accepted modality of treatment for rectal cancer. The indications for MIS have gradually been extended to locally advanced and locally recurrent rectal cancer as a result of technological advances in instrumentation, advances in surgical techniques, increased surgeon experience, and high volume center. However, safety and feasibility of laparoscopic surgery and robotic surgery in beyond total mesorectal excision (b-TME) and extended TME (e-TME) are not well established. This review summarizes the current evidence for MIS approach for b-TME/extended resections in rectal cancer. A systematic search was carried out in PubMed. Studies available in English related to MIS approach in b-TME/e-TME in rectal cancers were identified and evaluated. This review concludes MIS is feasible with good perioperative outcomes in b-TME/e-TME in carefully selected patients. Laparoscopic surgery has considerable learning curve and should be performed by experienced surgical teams. Robotic surgery is feasible and beneficial in complex resection in pelvis. However, evidence for long-term oncological outcomes of MIS in b-TME/e-TME is low and needs to be studied further by randomized controlled trial once enough numbers are possible in institutes with high volume rate.

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“…Invasion of blood vessels within the bowel wall is defines as intramural BVI and invasion of blood vessels outside the bowel wall (per colonic fat or subserosal fat) is defined as extramural BVI invasion [17][18][19]. Both Talbot et al [9] and Minsky et al [6] found that the extramural component of blood vessel invasion was not predictive of survival.…”

Section: Discussionmentioning

confidence: 99%

Rectal Cancer and Invasion of Veins: Importance in TNM Staging 2

Lorant¹,

Kiss²

2016

J Blood Lymph

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Summary: Accurate information about infiltration of the tumor to the various layers of the rectal wall is important. Material and methods:A histopathological study of surgical specimens from 351 surgical specimens from patients with adenocarcinoma of the rectum revealed invasion of veins by primary growth in almost 52%. Results:Follow-up studies showed that the corrected 5-year survival rate was significantly worse and liver metastases developed more frequently when venous invasion was present.Invasion of extramural veins was particularly significant whereas spread confined to intramural veins was less important. Invasion of large (thick-walled) veins was of greater consequence than invasion of small (thin-walled) veins and spread into thick-walled extramural veins, had greatest adverse influence of all.Venous spread of tumor takes place in parallel with local spread as measured by the Dukes' stage but exerts an influence on prognosis independent of the Dukes' stage.Similarly, veins invasion parallels the number of lymph nodes metastases but appears to exert an independent influence on prognosis. Conclusion:The venous spread provides a precise assessment of the likely behavior of rectal cancer, but does not replace indices such as the Dukes' stage, or the number of lymph nodes metastases in use.

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The prognostic impact of the number of lymph nodes retrieved after neoadjuvant chemoradiotherapy with mesorectal excision for rectal cancer

Abstract: In a neoadjuvant setting, ypN(+) disease was an independent risk factor for oncological outcomes. An absence of nodes does not represent an inferior oncological outcome. The number of nodes does not seen to impact survival and recurrence in ypN(-) patients.

Cited by 36 publications

References 36 publications

Optimal Lymph Node Harvest in Rectal Cancer (UICC Stages II and III) after Preoperative 5-FU–based Radiochemotherapy. Acetone Compression is a New and Highly Efficient Method

Optimal Lymph Node Harvest in Rectal Cancer (UICC Stages II and III) after Preoperative 5-FU–based Radiochemotherapy. Acetone Compression is a New and Highly Efficient Method

Minimal invasive approach for beyond total mesorectal excision/extended resections in rectal cancer

Rectal Cancer and Invasion of Veins: Importance in TNM Staging 2

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