Tumor regression in mesorectal lymphnodes after neoadjuvant chemoradiation for rectal cancer

Abstract Aims The histological modification produced by neoadjuvant chemoradiation on primary rectal cancer has been investigated by many authors, and a prognostic value of tumor regression grade (TRG) has been identified. Tumor regression grade on metastatic mesorectal lymphnodes has been never eva...

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Bibliographic Details
Published in:European journal of surgical oncology 2007-08, Vol.33 (6), p.724-728
Main Authors: Caricato, M, Ausania, F, De Dominicis, E, Vincenzi, B, Rabitti, C, Tonini, G, Cellini, F, Coppola, R
Format: Article
Language:English
Subjects:
Antineoplastic Combined Chemotherapy Protocols - therapeutic use
Chemoradiation therapy
Chemotherapy, Adjuvant
Dose Fractionation
Female
Fibrosis
Hematology, Oncology and Palliative Medicine
Humans
Lymph Nodes - pathology
Lymphatic Metastasis - pathology
Lymphatic Metastasis - prevention & control
Lymphnode regression grade (LRG)
Lymphnodes metastasis
Male
Mesorectum
Neoadjuvant Therapy
Neoplasm Staging
Neoplasm, Residual - pathology
Peritoneum
Radiotherapy, Adjuvant
Rectal cancer
Rectal Neoplasms - pathology
Rectal Neoplasms - surgery
Rectum
Remission Induction
Retrospective Studies
Surgery
Treatment Outcome
Tumor regression grade
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Summary:Abstract Aims The histological modification produced by neoadjuvant chemoradiation on primary rectal cancer has been investigated by many authors, and a prognostic value of tumor regression grade (TRG) has been identified. Tumor regression grade on metastatic mesorectal lymphnodes has been never evaluated. The purpose of this study is to analyse the TRG on mesorectal lymphnodes (lymphnode regression grade, LRG) after preoperative chemoradiation in rectal cancer patients and to determine the correlation with TRG of primary tumor. Methods Surgical specimens from 35 patients who underwent chemoradiation were included. LRG on mesorectal lymphnodes was assessed by immunohistochemistry. Response to treatment was evaluated by a 5-point LRG based on the ratio of residual tumor to fibrosis. Results Complete pathologic response (LRG 1) was observed in 18 patients (51%). In 4 patients (11%) no regression was observed (LRG 5). In 4 cases only reactive lymphnodes were found. LRG on lymphnodes significantly correlated with TRG on primary tumor ( p < 0.05). Conclusions Neoadjuvant chemoradiation determines a tumor regression on mesorectal lymphnodes as on primary tumor; further studies are needed to evaluate the prognostic value of LRG.
ISSN:0748-7983
1532-2157
DOI:10.1016/j.ejso.2007.01.023