title: Number of Lymph Nodes in Rectal Cancer is Correlated with Response to Preoperative Chemoradiotherapy but is not Associated with Patient Survival.
abstract: OBJECTIVE
  We aimed to clarify the oncological significance of the number of lymph nodes in rectal cancers treated with preoperative chemoradiotherapy.
  
  
  METHODS
  We studied 126 curatively operated patients with clinical T3-T4 and M0 rectal cancers. The number of lymph nodes and clinicopathological features were compared between the patients treated with surgery alone (OP group, n = 45) and those treated with preoperative chemoradiotherapy (50-50.4 Gy in 25-28 fractions with tegafur-uracil and leucovorin, CRT group, n = 81). Factors influencing lymph node count and its prognostic significance were analyzed.
  
  
  RESULTS
  The CRT group had significantly fewer lymph nodes than the OP group (12.4 vs. 21.1, P < 0.0001). High histological regression of rectal lesions was significantly correlated with decreased lymph node count in the CRT group. In the OP group, the 5-year cancer-specific survival rate of the patients with 12 or more lymph nodes was significantly better than those with fewer than 12 lymph nodes (75.1% vs. 33.3%, P = 0.02); in the CRT group, on the other hand, these survival rates did not differ (84.5% vs. 77.5%, P = 0.6).
  
  
  CONCLUSIONS
  The number of lymph nodes in rectal cancer was correlated with the response of primary rectal lesions to chemoradiotherapy, and was not associated with patient survival.
authors.forename: Soichiro
authors.initials: S
authors.lastname: Ishihara
authors.forename: Yoshihisa
authors.initials: Y
authors.lastname: Fukushima
authors.forename: Takuya
authors.initials: T
authors.lastname: Akahane
authors.forename: Atsushi
authors.initials: A
authors.lastname: Horiuchi
authors.forename: Ryu
authors.initials: R
authors.lastname: Shimada
authors.forename: Keisuke
authors.initials: K
authors.lastname: Nakamura
authors.forename: Yoshiko
authors.initials: Y
authors.lastname: Aoyagi
authors.forename: Tamuro
authors.initials: T
authors.lastname: Hayama
authors.forename: Hideki
authors.initials: H
authors.lastname: Yamada
authors.forename: Keijiro
authors.initials: K
authors.lastname: Nozawa
authors.forename: Keiji
authors.initials: K
authors.lastname: Matsuda
authors.forename: Yojiro
authors.initials: Y
authors.lastname: Hashiguchi
authors.forename: Toshiaki
authors.initials: T
authors.lastname: Watanabe
mesh_terms: D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use*; D017024:Chemotherapy, Adjuvant / Q000009:adverse effects / Q000401:mortality; D018450:Disease Progression; D018572:Disease-Free Survival; D019583:Dose Fractionation, Radiation; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D002955:Leucovorin / Q000008:administration & dosage; D008198:Lymph Nodes / Q000473:pathology*; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D020360:Neoadjuvant Therapy / Q000009:adverse effects / Q000401:mortality; D009367:Neoplasm Staging; D012004:Rectal Neoplasms / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D005641:Tegafur / Q000008:administration & dosage; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D005641:Tegafur; D002955:Leucovorin