Characteristics of rectal carcinomas that predict the presence of lymph node metastases: implications for patient selection for local therapy.
OBJECTIVE
It has been estimated that approximately 5% of middle and low rectal adenocarcinomas are amenable to local therapy. However, these treatment modalities are limited by their failure to identify and treat regional nodal metastases.


METHODS
This study was undertaken to evaluate the role of tumor size, depth of penetration into the rectal wall, degree of histologic differentiation, DNA ploidy status, and their combination on the presence or absence of metastases in perirectal lymph nodes. Logistic regression was used to quantitatively predict the probability of positive lymph nodes.


RESULTS
Tumor size did not correlate with the presence of nodal involvement; however, worsening degree of differentiation, increasing depth of wall penetration and aneuploidy did statistically correlate with the presence of nodal metastases. For any combination of tumor traits, aneuploidy markedly increased the probability of positive lymph nodes over that observed with diploid tumors.


CONCLUSIONS
The combination of degree of differentiation, depth of penetration, and ploidy status may be used to identify patients whose tumors may be adequately treated with local measures. For any combination of tumor traits, aneuploidy markedly increased the probability of positive lymph nodes over that observed with diploid tumors.
Zenni
G C
GC
Department of Surgery, Loyola University Medical Center, Maywood, Illinois 60153, USA.
Abraham
K
K
Harford
F J
FJ
Potocki
D M
DM
Herman
C
C
Dobrin
P B
PB
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004273:DNA, Neoplasm / Q000235:genetics; D005260:Female; D005434:Flow Cytometry; D006801:Humans; D008198:Lymph Nodes / Q000473:pathology*; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D018579:Patient Selection; D011003:Ploidies; D011379:Prognosis; D012004:Rectal Neoplasms / Q000473:pathology* / Q000601:surgery; D012044:Regression Analysis; D012189:Retrospective Studies
D004273:DNA, Neoplasm