Clinical Significance of Extramural Tumor Deposits in the Lateral Pelvic Lymph Node Area in Low Rectal Cancer: A Retrospective Study at Two Institutions

Overview

Journal Ann Surg Oncol

Publisher Springer

Specialty Oncology

Date 2016 Jul 10

PMID 27393567

Citations 20

Authors

Ryoma Yagi

Yoshifumi Shimada

Hitoshi Kameyama

Yosuke Tajima

Takuma Okamura

Jun Sakata

Takashi Kobayashi

Shin-Ichi Kosugi

Toshifumi Wakai

Hitoshi Nogami

Satoshi Maruyama

Yasumasa Takii

Takashi Kawasaki

Kei-Ichi Honma

Affiliations

Soon will be listed here.

Abstract

Background: The presence of extramural tumor deposits without lymph node structure (EX) is an important prognostic factor for patients with colorectal cancer. However, the clinical significance of EX in the lateral pelvic lymph node area (LP-EX) remains unclear. This study aimed to determine the prognostic implications of LP-EX for patients with low rectal cancer.

Methods: This retrospective study involved 172 consecutive patients with stage 2 or 3 low rectal cancer who underwent curative surgery including lateral pelvic lymph node (LPLN) dissection. The patients were classified into the following three groups according to the metastatic status of the LPLN area: patients without metastasis (no-LP-M group), patients with lymph node metastasis (LP-LNM group), and patients with EX (LP-EX group). Potential prognostic factors of overall survival (OS) and relapse-free survival (RFS) were identified in uni- and multivariate analyses.

Results: Classification assigned 131 patients (76 %) to the no-LP-M group, 27 patients (16 %) to the LP-LNM group, and 14 patients (8 %) to the LP-EX group. The 5-year OS rate was 80.3 % in the no-LP-M group, 61.1 % in the LP-LNM group, and 34.9 % in the LP-EX group (P < 0.001). The corresponding 5-year RFS rates were 62.2, 33.8, and 14.3 %, respectively (P < 0.001). A multivariate Cox proportional hazards regression analysis showed that the presence of LP-EX was an independent prognostic factor for OS (P = 0.006) and RFS (P = 0.001).

Conclusions: The LP-EX classification is a useful pathologic parameter that can be used to stratify patients with metastasis in the LPLN area.

Citing Articles

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Feng F, Liu Y, Bao J, Hong R, Hu S, Hu C Abdom Radiol (NY). 2023; 48(11):3310-3321.

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Progress in the diagnosis of lymph node metastasis in rectal cancer: a review.

Peng W, Qiao H, Mo L, Guo Y Front Oncol. 2023; 13:1167289.

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Clinical significance of metastatic tumor deposit foci in rectal cancer in the lateral pelvic lymph node area.

Yamai D, Shimada Y, Nakano M, Ozeki H, Matsumoto A, Abe K Int J Clin Oncol. 2023; 28(10):1388-1397.

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