Management, treatment and prognostic significance of lateral lymph node metastases in rectal cancer—a regional cohort study
(2021) In International Journal of Colorectal Disease 36(12). p.2707-2714- Abstract
Purpose: Lateral lymph node metastases in rectal cancer remain a clinical challenge. Different treatment regimens have been suggested. This retrospective regional cohort study examines outcome after combined oncological and surgical treatment of MRI-positive lateral lymph nodes (LLN). Methods: Data from the Swedish Colorectal Cancer Registry (SCRCR) and patient records were used for retrospective analysis of resected high-risk rectal cancers between 2009 and 2014. The aim was to compare tumour characteristics, neoadjuvant therapy, recurrence and outcome after lateral lymph node dissection. Results: One thousand and one hundred nineteen cases were identified and after exclusion 344 patients with cT3–T4 ≤ 10 cm from the anal verge were... (More)
Purpose: Lateral lymph node metastases in rectal cancer remain a clinical challenge. Different treatment regimens have been suggested. This retrospective regional cohort study examines outcome after combined oncological and surgical treatment of MRI-positive lateral lymph nodes (LLN). Methods: Data from the Swedish Colorectal Cancer Registry (SCRCR) and patient records were used for retrospective analysis of resected high-risk rectal cancers between 2009 and 2014. The aim was to compare tumour characteristics, neoadjuvant therapy, recurrence and outcome after lateral lymph node dissection. Results: One thousand and one hundred nineteen cases were identified and after exclusion 344 patients with cT3–T4 ≤ 10 cm from the anal verge were analysed. Thirty (8.7%) patients with MRI-positive LLN were identified. Synchronous distant metastases were associated with MRI-positive LLN (p-value 0.019). Long-course chemoradiotherapy was clinical practice in cases of MRI-positive LLN. No differences in local (p-value 0.154) or distant (p-value 0.343) recurrence rates between MRI-positive LLN patients and MRI-negative patients were detected. Only four patients underwent lateral lymph node dissection (LLND). There was no significant difference in overall survival during follow-up between the MRI-negative (CI at 95%; 99–109 months) and MRI-positive group (CI at 95%; 69–108 months; p-value 0.14). Conclusion: Lateral lymph node metastases present a challenging clinical situation. The present study shows that combination of neoadjuvant therapy and selective LLND is an applicable strategy in cases of MRI-positive LLN.
(Less)
- author
- Agger, E. LU ; Åkerlund, V. ; Ekberg, O. LU ; Jörgren, F. LU ; Lydrup, M. L. LU and Buchwald, P. LU
- organization
- publishing date
- 2021
- type
- Contribution to journal
- publication status
- published
- subject
- keywords
- Chemoradiotherapy, Lateral lymph node metastases, Rectal cancer
- in
- International Journal of Colorectal Disease
- volume
- 36
- issue
- 12
- pages
- 2707 - 2714
- publisher
- Springer
- external identifiers
-
- pmid:34487231
- scopus:85114366980
- ISSN
- 0179-1958
- DOI
- 10.1007/s00384-021-04018-1
- language
- English
- LU publication?
- yes
- id
- 150d7acb-c875-475c-ade5-c75c14975a3f
- date added to LUP
- 2021-09-30 15:00:48
- date last changed
- 2024-08-10 21:56:57
@article{150d7acb-c875-475c-ade5-c75c14975a3f, abstract = {{<p>Purpose: Lateral lymph node metastases in rectal cancer remain a clinical challenge. Different treatment regimens have been suggested. This retrospective regional cohort study examines outcome after combined oncological and surgical treatment of MRI-positive lateral lymph nodes (LLN). Methods: Data from the Swedish Colorectal Cancer Registry (SCRCR) and patient records were used for retrospective analysis of resected high-risk rectal cancers between 2009 and 2014. The aim was to compare tumour characteristics, neoadjuvant therapy, recurrence and outcome after lateral lymph node dissection. Results: One thousand and one hundred nineteen cases were identified and after exclusion 344 patients with cT3–T4 ≤ 10 cm from the anal verge were analysed. Thirty (8.7%) patients with MRI-positive LLN were identified. Synchronous distant metastases were associated with MRI-positive LLN (p-value 0.019). Long-course chemoradiotherapy was clinical practice in cases of MRI-positive LLN. No differences in local (p-value 0.154) or distant (p-value 0.343) recurrence rates between MRI-positive LLN patients and MRI-negative patients were detected. Only four patients underwent lateral lymph node dissection (LLND). There was no significant difference in overall survival during follow-up between the MRI-negative (CI at 95%; 99–109 months) and MRI-positive group (CI at 95%; 69–108 months; p-value 0.14). Conclusion: Lateral lymph node metastases present a challenging clinical situation. The present study shows that combination of neoadjuvant therapy and selective LLND is an applicable strategy in cases of MRI-positive LLN.</p>}}, author = {{Agger, E. and Åkerlund, V. and Ekberg, O. and Jörgren, F. and Lydrup, M. L. and Buchwald, P.}}, issn = {{0179-1958}}, keywords = {{Chemoradiotherapy; Lateral lymph node metastases; Rectal cancer}}, language = {{eng}}, number = {{12}}, pages = {{2707--2714}}, publisher = {{Springer}}, series = {{International Journal of Colorectal Disease}}, title = {{Management, treatment and prognostic significance of lateral lymph node metastases in rectal cancer—a regional cohort study}}, url = {{http://dx.doi.org/10.1007/s00384-021-04018-1}}, doi = {{10.1007/s00384-021-04018-1}}, volume = {{36}}, year = {{2021}}, }