Examined lymph node numbers influence prognosis in rectal cancer treated with neoadjuvant therapy
Background: The number of lymph nodes examined (LNe) is often insufficient in patients with rectal cancer (RC) treated with neoadjuvant therapy; however, its prognostic value remains controversial. Thus, we retrospectively explored whether LNe had an influence on staging and prognosis and investigat...
| Main Authors: | , , , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Elsevier
2023-07-01
|
| Series: | Cancer Pathogenesis and Therapy |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2949713223000010 |
| _version_ | 1827876689400561664 |
|---|---|
| author | Liyu Zhu Lin Wang Zhidong Gao Yujian Zeng Kaixiong Tao Quan Wang Xinming Li Huanhu Zhang Zhanlong Shen Jing Zhou Kai Shen Yingjiang Ye Aiwen Wu |
| author_facet | Liyu Zhu Lin Wang Zhidong Gao Yujian Zeng Kaixiong Tao Quan Wang Xinming Li Huanhu Zhang Zhanlong Shen Jing Zhou Kai Shen Yingjiang Ye Aiwen Wu |
| author_sort | Liyu Zhu |
| collection | DOAJ |
| description | Background: The number of lymph nodes examined (LNe) is often insufficient in patients with rectal cancer (RC) treated with neoadjuvant therapy; however, its prognostic value remains controversial. Thus, we retrospectively explored whether LNe had an influence on staging and prognosis and investigated whether there was a cut-off value for better prognosis in patients with RC treated with neoadjuvant therapy. Methods: Data were collected from seven prospective hospital databases in China from July 2002 to May 2018. Binary logistic regression models were used to predict lymph node metastasis. The cut-off value for LNe was determined using X-tile 3.6.1. Survival outcomes and risk factors were analyzed using the log-rank test and Cox regression model. Results: A total of 482 patients were included, of whom 459 had complete overall survival (OS) information. Using the percentile method, the total number of lymph nodes examined (TLNe) was 14–16 (40th–60th percentile), and the proportion of patients with lymph node metastasis reached a maximum of 48.1%. Cox multivariate analysis showed that the odds ratio (OR) remained the highest when TLNe was 14–16 (OR = 3.379, P = 0.003). The 3-year and 5-year OS were 85.4% and 77.8%, respectively. Negative lymph nodes examined (NLNe) of ≤6 was an independent risk factor for 3-year and 5-year OS (3-year OS 71.1% vs. 85.9%, P = 0.004; 5-year OS 66.3% vs. 74.3%, P = 0.035). Subgroup analysis for patients with ypN + showed that higher 3-year and 5-year OS were achieved when the TLNe was >10, 78.8% vs. 54.0% (P = 0.005), and 60.8% vs. 36.0% (P = 0.012), respectively. Patients with ypN0M0 had a higher 5-year OS when the TLNe was >19 (P = 0.055). Conclusion: The TLNe and NLNe influenced the staging accuracy and demonstrated prognostic value in patients with RC treated with neoadjuvant therapy. |
| first_indexed | 2024-03-12T17:25:01Z |
| format | Article |
| id | doaj.art-ebc428f7374e43ecae08e261b34336aa |
| institution | Directory Open Access Journal |
| issn | 2949-7132 |
| language | English |
| last_indexed | 2024-03-12T17:25:01Z |
| publishDate | 2023-07-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Cancer Pathogenesis and Therapy |
| spelling | doaj.art-ebc428f7374e43ecae08e261b34336aa2023-08-05T05:18:37ZengElsevierCancer Pathogenesis and Therapy2949-71322023-07-0113168176Examined lymph node numbers influence prognosis in rectal cancer treated with neoadjuvant therapyLiyu Zhu0Lin Wang1Zhidong Gao2Yujian Zeng3Kaixiong Tao4Quan Wang5Xinming Li6Huanhu Zhang7Zhanlong Shen8Jing Zhou9Kai Shen10Yingjiang Ye11Aiwen Wu12Department of Gastroenterological Surgery, Peking University People's Hospital, Beijing 100044, China; Laboratory of Surgical Oncology, Beijing Key Laboratory of Colorectal Cancer Diagnosis and Treatment Research, Peking University People's Hospital, Beijing 100044, ChinaKey Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Gastrointestinal Surgery, Peking University Cancer Hospital & Institute, Beijing 100142, ChinaDepartment of Gastroenterological Surgery, Peking University People's Hospital, Beijing 100044, China; Laboratory of Surgical Oncology, Beijing Key Laboratory of Colorectal Cancer Diagnosis and Treatment Research, Peking University People's Hospital, Beijing 100044, China; Corresponding author: Department of Gastroenterological Surgery, Laboratory of Surgical Oncology, Beijing Key Laboratory of Colorectal Cancer Diagnosis and Treatment Research, Peking University People's Hospital, Beijing 100044, China.Yunnan Institute of Digestive Disease, Department of Gastrointestinal and Hernia Surgery, The First Affiliated Hospital of Kunming Medical University, Kunming, Yunnan 650032, ChinaDepartment of Gastrointestinal Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430022, ChinaDepartment of Gastrointestinal and Anal Surgery, The First Hospital of Jilin University, Changchun, Jilin 130021, ChinaDepartment of Gastrointestinal and Anal Surgery, Huangshi Central Hospital, Huangshi, Hubei 435000, ChinaDepartment of Gastrointestinal Surgery, Weihai Municipal Hospital, Weihai, Shandong 264200, ChinaDepartment of Gastroenterological Surgery, Peking University People's Hospital, Beijing 100044, China; Laboratory of Surgical Oncology, Beijing Key Laboratory of Colorectal Cancer Diagnosis and Treatment Research, Peking University People's Hospital, Beijing 100044, ChinaDepartment of Gastroenterological Surgery, Peking University People's Hospital, Beijing 100044, China; Laboratory of Surgical Oncology, Beijing Key Laboratory of Colorectal Cancer Diagnosis and Treatment Research, Peking University People's Hospital, Beijing 100044, ChinaDepartment of Gastroenterological Surgery, Peking University People's Hospital, Beijing 100044, China; Laboratory of Surgical Oncology, Beijing Key Laboratory of Colorectal Cancer Diagnosis and Treatment Research, Peking University People's Hospital, Beijing 100044, ChinaDepartment of Gastroenterological Surgery, Peking University People's Hospital, Beijing 100044, China; Corresponding author: Department of Gastroenterological Surgery, Peking University People's Hospital, Beijing 100044, China.Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Gastrointestinal Surgery, Peking University Cancer Hospital & Institute, Beijing 100142, China; Corresponding author: Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Gastrointestinal Surgery, Peking University Cancer Hospital & Institute, No. 52, Fucheng Road, Haidian District, Beijing 100142, China.Background: The number of lymph nodes examined (LNe) is often insufficient in patients with rectal cancer (RC) treated with neoadjuvant therapy; however, its prognostic value remains controversial. Thus, we retrospectively explored whether LNe had an influence on staging and prognosis and investigated whether there was a cut-off value for better prognosis in patients with RC treated with neoadjuvant therapy. Methods: Data were collected from seven prospective hospital databases in China from July 2002 to May 2018. Binary logistic regression models were used to predict lymph node metastasis. The cut-off value for LNe was determined using X-tile 3.6.1. Survival outcomes and risk factors were analyzed using the log-rank test and Cox regression model. Results: A total of 482 patients were included, of whom 459 had complete overall survival (OS) information. Using the percentile method, the total number of lymph nodes examined (TLNe) was 14–16 (40th–60th percentile), and the proportion of patients with lymph node metastasis reached a maximum of 48.1%. Cox multivariate analysis showed that the odds ratio (OR) remained the highest when TLNe was 14–16 (OR = 3.379, P = 0.003). The 3-year and 5-year OS were 85.4% and 77.8%, respectively. Negative lymph nodes examined (NLNe) of ≤6 was an independent risk factor for 3-year and 5-year OS (3-year OS 71.1% vs. 85.9%, P = 0.004; 5-year OS 66.3% vs. 74.3%, P = 0.035). Subgroup analysis for patients with ypN + showed that higher 3-year and 5-year OS were achieved when the TLNe was >10, 78.8% vs. 54.0% (P = 0.005), and 60.8% vs. 36.0% (P = 0.012), respectively. Patients with ypN0M0 had a higher 5-year OS when the TLNe was >19 (P = 0.055). Conclusion: The TLNe and NLNe influenced the staging accuracy and demonstrated prognostic value in patients with RC treated with neoadjuvant therapy.http://www.sciencedirect.com/science/article/pii/S2949713223000010Lymph nodes examinedPrognosisStaging accuracyRectal cancerNeoadjuvant therapy |
| spellingShingle | Liyu Zhu Lin Wang Zhidong Gao Yujian Zeng Kaixiong Tao Quan Wang Xinming Li Huanhu Zhang Zhanlong Shen Jing Zhou Kai Shen Yingjiang Ye Aiwen Wu Examined lymph node numbers influence prognosis in rectal cancer treated with neoadjuvant therapy Cancer Pathogenesis and Therapy Lymph nodes examined Prognosis Staging accuracy Rectal cancer Neoadjuvant therapy |
| title | Examined lymph node numbers influence prognosis in rectal cancer treated with neoadjuvant therapy |
| title_full | Examined lymph node numbers influence prognosis in rectal cancer treated with neoadjuvant therapy |
| title_fullStr | Examined lymph node numbers influence prognosis in rectal cancer treated with neoadjuvant therapy |
| title_full_unstemmed | Examined lymph node numbers influence prognosis in rectal cancer treated with neoadjuvant therapy |
| title_short | Examined lymph node numbers influence prognosis in rectal cancer treated with neoadjuvant therapy |
| title_sort | examined lymph node numbers influence prognosis in rectal cancer treated with neoadjuvant therapy |
| topic | Lymph nodes examined Prognosis Staging accuracy Rectal cancer Neoadjuvant therapy |
| url | http://www.sciencedirect.com/science/article/pii/S2949713223000010 |
| work_keys_str_mv | AT liyuzhu examinedlymphnodenumbersinfluenceprognosisinrectalcancertreatedwithneoadjuvanttherapy AT linwang examinedlymphnodenumbersinfluenceprognosisinrectalcancertreatedwithneoadjuvanttherapy AT zhidonggao examinedlymphnodenumbersinfluenceprognosisinrectalcancertreatedwithneoadjuvanttherapy AT yujianzeng examinedlymphnodenumbersinfluenceprognosisinrectalcancertreatedwithneoadjuvanttherapy AT kaixiongtao examinedlymphnodenumbersinfluenceprognosisinrectalcancertreatedwithneoadjuvanttherapy AT quanwang examinedlymphnodenumbersinfluenceprognosisinrectalcancertreatedwithneoadjuvanttherapy AT xinmingli examinedlymphnodenumbersinfluenceprognosisinrectalcancertreatedwithneoadjuvanttherapy AT huanhuzhang examinedlymphnodenumbersinfluenceprognosisinrectalcancertreatedwithneoadjuvanttherapy AT zhanlongshen examinedlymphnodenumbersinfluenceprognosisinrectalcancertreatedwithneoadjuvanttherapy AT jingzhou examinedlymphnodenumbersinfluenceprognosisinrectalcancertreatedwithneoadjuvanttherapy AT kaishen examinedlymphnodenumbersinfluenceprognosisinrectalcancertreatedwithneoadjuvanttherapy AT yingjiangye examinedlymphnodenumbersinfluenceprognosisinrectalcancertreatedwithneoadjuvanttherapy AT aiwenwu examinedlymphnodenumbersinfluenceprognosisinrectalcancertreatedwithneoadjuvanttherapy |