title: Lymph nodes regression grade is a predictive marker for rectal cancer after neoadjuvant therapy and radical surgery.
abstract: Neoadjuvant therapy (NT) for rectal cancer (RC) reduces primary tumors and involved lymph nodes. While a prognostic value of tumor regression grade (TRG) has been identified, involved lymph node regression grade (LRG) has not been systematically evaluated. Here, we evaluated the association of LRG with oncologic outcomes of RC patients after NT followed by radical surgery. 347 patients with locally advanced RC who received NT and then underwent radical surgery were retrospectively recruited between 2004 and 2011. Response to NT was evaluated by a 3-tier LRG and TRG based on the ratio of residual tumor to fibrosis. LRG was assessed in all patients (LRG 0, 170 patients [49.0%]; LRG 1, 100 patients [28.8%]; and LRG 2, 77 patients [22.2%]). LRG correlated with 5-year distant metastasis and 5-year disease free survival (p=0.029 and 0.023, respectively). LRG also correlated with TRG (p=0.017). We conclude that the LRG system may be an independent predictive factor of long-term oncologic outcomes of rectal cancer patients after NT and radical surgery.
authors.affiliation: General Surgery Department, Affiliated Hospital/Clinical Medical College of Chengdu University, Chengdu, P.R. China.
authors.forename: Jun
authors.initials: J
authors.lastname: Li
authors.affiliation: General Surgery Department, Affiliated Hospital/Clinical Medical College of Chengdu University, Chengdu, P.R. China.
authors.forename: Jiatian
authors.initials: J
authors.lastname: Yuan
authors.affiliation: General Surgery Department, Second Affiliated Hospital of Jilin University, Changchun, P.R. China.
authors.forename: Hao
authors.initials: H
authors.lastname: Liu
authors.affiliation: General Surgery Department, Xuzhou Central Hospital, Xuzhou, P.R. China.
authors.forename: Jie
authors.initials: J
authors.lastname: Yin
authors.affiliation: Surgical Department of Gastrointestinal Diseases, Beijing Youan Hospital of Capital Medical University, Beijing, P.R. China.
authors.forename: Sai
authors.initials: S
authors.lastname: Liu
authors.affiliation: Internal Medicine-Oncology, Cancer Institute/Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, P.R. China.
authors.forename: Feng
authors.initials: F
authors.lastname: Du
authors.affiliation: Gastrointestinal Tumor Surgery, Hubei Cancer Hospital, Wuhan, P.R. China.
authors.forename: Junjie
authors.initials: J
authors.lastname: Hu
authors.affiliation: Department of Pathology, Affiliated Hospital/Clinical Medical College of Chengdu University, Chengdu, P.R. China.
authors.forename: Ci
authors.initials: C
authors.lastname: Li
authors.affiliation: Department of Radiology, Affiliated Hospital/Clinical Medical College of Chengdu University, Chengdu, P.R. China.
authors.forename: Xiangke
authors.initials: X
authors.lastname: Niu
authors.affiliation: General Surgery Department, Affiliated Hospital/Clinical Medical College of Chengdu University, Chengdu, P.R. China.
authors.forename: Bo
authors.initials: B
authors.lastname: Lv
authors.affiliation: Central Lab, Affiliated Hospital/Clinical Medical College of Chengdu University, Chengdu, P.R. China.
authors.forename: Shasha
authors.initials: S
authors.lastname: Xing
mesh_terms: D000328:Adult; D000368:Aged; D059248:Chemoradiotherapy / Q000379:methods; D003131:Combined Modality Therapy; D013505:Digestive System Surgical Procedures / Q000379:methods; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008207:Lymphatic Metastasis / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D020360:Neoadjuvant Therapy / Q000379:methods; D060787:Neoplasm Grading; D009367:Neoplasm Staging; D011379:Prognosis; D012004:Rectal Neoplasms / Q000401:mortality / Q000473:pathology* / Q000628:therapy; D012189:Retrospective Studies
keywords: lymph node; neoadjuvant therapy; rectal cancer; regression grading