Lateral Lymph Node Metastasis Is a Major Cause of Locoregional Recurrence in Rectal Cancer Treated with Preoperative Chemoradiotherapy and Curative Resection

Background In rectal cancer patients treated with preoperative chemoradiotherapy (CRT) and curative resection, we evaluated the effect of clinical parameters on lateral pelvic recurrence and made an attempt to identify a risk factor for lateral pelvic recurrence. Methods The study involved 366 patie...

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Bibliographic Details
Published in:Annals of surgical oncology 2008-03, Vol.15 (3), p.729-737
Main Authors: Kim, Tae Hyun, Jeong, Seung-Yong, Choi, Dong Hyun, Kim, Dae Yong, Jung, Kyung Hae, Moon, Sung Ho, Chang, Hee Jin, Lim, Seok-Byung, Choi, Hyo Seong, Park, Jae-Gahb
Format: Article
Language:English
Subjects:
Adult
Aged
Aged, 80 and over
Chemotherapy, Adjuvant
Colectomy
Female
Gastrointestinal Oncology
Humans
Lymph Nodes - pathology
Lymphatic Metastasis
Male
Medicine
Medicine & Public Health
Middle Aged
Neoadjuvant Therapy
Neoplasm Recurrence, Local - etiology
Neoplasm Recurrence, Local - pathology
Oncology
Radiotherapy, Adjuvant
Rectal Neoplasms - pathology
Rectal Neoplasms - therapy
Risk Factors
Surgery
Surgical Oncology
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Summary:Background In rectal cancer patients treated with preoperative chemoradiotherapy (CRT) and curative resection, we evaluated the effect of clinical parameters on lateral pelvic recurrence and made an attempt to identify a risk factor for lateral pelvic recurrence. Methods The study involved 366 patients who underwent preoperative CRT and curative resection between October 2001 and December 2005. Clinical parameters such as gender, age, tumor size, histologic type, cT and cN classification, ypT and ypN classification, circumferential resection margin, tumor regression grade, chemotherapeutic regimen, and lateral lymph node size were analyzed to identify risk factors associated with lateral pelvic recurrence. Results Of the 366 patients, 29 patients (7.9%) had locoregional recurrence: 6 (20.7%) with central pelvic recurrence and 24 (82.7%) had lateral pelvic recurrence, of which 1 had simultaneous central and lateral pelvic recurrence. Multivariate analysis showed that ypN classification and lateral lymph node size were significantly associated with lateral pelvic recurrence ( P  
ISSN:1068-9265
1534-4681
DOI:10.1245/s10434-007-9696-x