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Predictors and histological effects of preoperative chemoradiotherapy for rectal cancer and control of lateral lymph node metastasis
INTRODUCTION: Standard treatment strategy for low rectal cancer in Japan is different from Western countries. Total mesorectum excision (TME) + lateral lymph node dissection (LLND) is mainly carried out in Japan, whereas neoadjuvant chemoradiotherapy (nCRT) + TME is selected in Western countries. Th...
Autores principales: | , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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BioMed Central
2022
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Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9270805/ https://www.ncbi.nlm.nih.gov/pubmed/35804299 http://dx.doi.org/10.1186/s12876-022-02414-7 |
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author | Miyakita, Hiroshi Chan, Lin Fung Okada, Kazutake Kayano, Hajime Mori, Masaki Sadahiro, Sotaro Yamamoto, Seiichiro |
author_facet | Miyakita, Hiroshi Chan, Lin Fung Okada, Kazutake Kayano, Hajime Mori, Masaki Sadahiro, Sotaro Yamamoto, Seiichiro |
author_sort | Miyakita, Hiroshi |
collection | PubMed |
description | INTRODUCTION: Standard treatment strategy for low rectal cancer in Japan is different from Western countries. Total mesorectum excision (TME) + lateral lymph node dissection (LLND) is mainly carried out in Japan, whereas neoadjuvant chemoradiotherapy (nCRT) + TME is selected in Western countries. There is no clear definition of preoperative diagnosis of lateral lymph node metastasis. If we can predict lateral lymph node swelling that can be managed by nCRT from lateral lymph node swelling that require surgical resection, clinical benefit is significant. In the current study we assessed characteristics of the lateral lymph node recurrence (LLNR) and LLND that can be managed by nCRT. PATIENTS AND METHODS: Patients with low rectal cancer (n = 168) underwent nCRT between 2009 and 2016. We evaluated CEA, neutrophil/lymphocyte ratio (NLR), platelet/lymphocyte ratio (PLR), and lateral lymph node short axis pre and post nCRT, respectively, and also evaluated tumor shrinkage rate, tumor regression grade (TRG). We evaluated the relationship between each and LLNR. RESULTS: LLND was not carried out all patients. Factors associated with LLNR were PLR and lymph node short axis pre and post nCRT. (p = 0.0269, 0.0278, p < 0.0001, p < 0.0001, respectively). Positive recurrence cut-off values of lateral lymph node short-axis calculated were 11.6 mm pre nCRT and 5.5 mm post nCRT. CONCLUSION: Results suggest that PLR before and after CRT was associated with control of LLNR, and LLND should be performed on lateral lymph nodes with short-axis of 5 mm and 11 mm pre and post nCRT. |
format | Online Article Text |
id | pubmed-9270805 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-92708052022-07-10 Predictors and histological effects of preoperative chemoradiotherapy for rectal cancer and control of lateral lymph node metastasis Miyakita, Hiroshi Chan, Lin Fung Okada, Kazutake Kayano, Hajime Mori, Masaki Sadahiro, Sotaro Yamamoto, Seiichiro BMC Gastroenterol Research INTRODUCTION: Standard treatment strategy for low rectal cancer in Japan is different from Western countries. Total mesorectum excision (TME) + lateral lymph node dissection (LLND) is mainly carried out in Japan, whereas neoadjuvant chemoradiotherapy (nCRT) + TME is selected in Western countries. There is no clear definition of preoperative diagnosis of lateral lymph node metastasis. If we can predict lateral lymph node swelling that can be managed by nCRT from lateral lymph node swelling that require surgical resection, clinical benefit is significant. In the current study we assessed characteristics of the lateral lymph node recurrence (LLNR) and LLND that can be managed by nCRT. PATIENTS AND METHODS: Patients with low rectal cancer (n = 168) underwent nCRT between 2009 and 2016. We evaluated CEA, neutrophil/lymphocyte ratio (NLR), platelet/lymphocyte ratio (PLR), and lateral lymph node short axis pre and post nCRT, respectively, and also evaluated tumor shrinkage rate, tumor regression grade (TRG). We evaluated the relationship between each and LLNR. RESULTS: LLND was not carried out all patients. Factors associated with LLNR were PLR and lymph node short axis pre and post nCRT. (p = 0.0269, 0.0278, p < 0.0001, p < 0.0001, respectively). Positive recurrence cut-off values of lateral lymph node short-axis calculated were 11.6 mm pre nCRT and 5.5 mm post nCRT. CONCLUSION: Results suggest that PLR before and after CRT was associated with control of LLNR, and LLND should be performed on lateral lymph nodes with short-axis of 5 mm and 11 mm pre and post nCRT. BioMed Central 2022-07-08 /pmc/articles/PMC9270805/ /pubmed/35804299 http://dx.doi.org/10.1186/s12876-022-02414-7 Text en © The Author(s) 2022 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data. |
spellingShingle | Research Miyakita, Hiroshi Chan, Lin Fung Okada, Kazutake Kayano, Hajime Mori, Masaki Sadahiro, Sotaro Yamamoto, Seiichiro Predictors and histological effects of preoperative chemoradiotherapy for rectal cancer and control of lateral lymph node metastasis |
title | Predictors and histological effects of preoperative chemoradiotherapy for rectal cancer and control of lateral lymph node metastasis |
title_full | Predictors and histological effects of preoperative chemoradiotherapy for rectal cancer and control of lateral lymph node metastasis |
title_fullStr | Predictors and histological effects of preoperative chemoradiotherapy for rectal cancer and control of lateral lymph node metastasis |
title_full_unstemmed | Predictors and histological effects of preoperative chemoradiotherapy for rectal cancer and control of lateral lymph node metastasis |
title_short | Predictors and histological effects of preoperative chemoradiotherapy for rectal cancer and control of lateral lymph node metastasis |
title_sort | predictors and histological effects of preoperative chemoradiotherapy for rectal cancer and control of lateral lymph node metastasis |
topic | Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9270805/ https://www.ncbi.nlm.nih.gov/pubmed/35804299 http://dx.doi.org/10.1186/s12876-022-02414-7 |
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