Optimal Lymph Node Yield for Survival Prediction in Rectal Cancer Patients After Neoadjuvant Therapy

doi:10.2147/CMAR.S328666

CNU IR > Pharmacy and Science > Dept. of Cosmetic Science and institute of cosmetic science > Periodical Articles > Item 310902800/34518

Please use this identifier to cite or link to this item: https://ir.cnu.edu.tw/handle/310902800/34518

Title:	Optimal Lymph Node Yield for Survival Prediction in Rectal Cancer Patients After Neoadjuvant Therapy
Authors:	Lin, Yu-Min Chou, Chia-Lin Kuo, Yu-Hsuan Wu, Hung-Chang Tsai, Chia-Jen Ho, Chung-Han Chen, Yi-Chen Yang, Ching-Chieh Lin, Cheng-Wei
Contributors:	Chi Mei Med Ctr, Dept Internal Med, Div Hepatogastroenterol Chi Mei Med Ctr, Dept Surg, Div Colorectal Surg Chung Hwa Univ Med Technol, Dept Med Lab Sci & Biotechnol Chi Mei Med Ctr, Dept Internal Med, Div Hematol & Oncol Chia Nan Univ Pharm & Sci, Dept Cosmet Sci Chia Nan Univ Pharm & Sci, Dept Pharm Chi Mei Med Ctr, Dept Radiat Oncol Chi Mei Med Ctr, Dept Med Res Southern Taiwan Univ Sci & Technol, Dept Informat Management Taipei Med Univ, Coll Med, Sch Med, Dept Biochem & Mol Cell Biol Taipei Med Univ, Coll Med, Grad Inst Med Sci Taipei Med Univ, Wan Fang Hosp, Cell Physiol & Mol Image Res Ctr
Keywords:	rectal cancer neoadjuvant therapy lymph node yield quality survival
Date:	2021
Issue Date:	2023-11-11 12:00:34 (UTC+8)
Publisher:	DOVE MEDICAL PRESS LTD
Abstract:	Purpose: A lymph node (LN) yield >12 is required to for accurate determination of nodal status for colorectal cancer but cannot always be achieved after neoadjuvant therapy. This study aims to determine the difference in LN yield from rectal cancer patients treated with and without neoadjuvant therapy and the effects of specific LN yields on survival. Patients and Methods: The study cohort included a total of 4344 rectal cancer patients treated between January 2007 and December 2015, 2260 (52.03%) of whom received neoadjuvant therapy. Data were retrieved from the Taiwan nationwide cancer registry database. The minimum acceptable LN yield below 12 was investigated using the maximum area under the ROC curve. Results: The median LN yield was 12 (8-17) for patients who received neoadjuvant therapy and 17 (13-24) for those who did not. The recommended LN yield >12 was achieved in 82.73% of patients without and 57.96% of those with neoadjuvant therapy (p < 0.0001). Patients with LN yield >12 had a higher OS probability than did those with LN <12 (OR, 1.33; 95% CI, 1.06-1.66; p = 0.0124). However, the predictive accuracy for survival was greater for LN yield >10 (AUC, 0.7767) than cut-offs of 12, 8, or 6, especially in patients with pathologically-negative nodes (AUC, 0.7660). Conclusion: Neoadjuvant therapy significantly reduces the LN yield in subsequent surgery. A lower yield (LN > 10) may be adequate for nodal evaluation in rectal cancer patients after neoadjuvant therapy.
Relation:	CANCER MANAG RES, v.13, pp.8037-8047
Appears in Collections:	[Dept. of Cosmetic Science and institute of cosmetic science] Periodical Articles [Dept. of Pharmacy] Periodical Articles

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