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Resected irradiated rectal cancers: Are twelve lymph nodes really necessary in the era of neoadjuvant therapy?

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Cox, ML; Adam, MA; Shenoi, MM; Turner, MC; Sun, Z; Mantyh, CR; Migaly, J
Published in: Am J Surg
September 2018

BACKGROUND: Our study aims to identify the minimum number of lymph nodes (LN) associated with improved survival in patients who underwent NRT for stage II-III rectal cancer. METHODS: Adults with clinical stage II and III rectal adenocarcinoma in the National Cancer Data Base were stratified by NRT. Multivariable Cox regression modeling with restricted cubic splines was used to determine the minimum number of LNs associated with improved survival. RESULTS: Of 38,363 patients, 76% received NRT. After adjustment, a LNY≥12 was associated with improved survival among patients receiving NRT (HR 0.79, p < 0.0001) and those without NRT (HR 0.88, p = 0.04). Among patients receiving NRT, factors independently associated with LNY≥12 were younger age, private insurance, low comorbidity score, a recent year of diagnosis, higher T stage and grade, APR resection, and academic institution. CONCLUSIONS: A minimum LNY of 12 confers a survival benefit for rectal cancer patients regardless of receiving neoadjuvant radiation therapy.

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Published In

Am J Surg

DOI

EISSN

1879-1883

Publication Date

September 2018

Volume

216

Issue

3

Start / End Page

444 / 449

Location

United States

Related Subject Headings

  • United States
  • Time Factors
  • Survival Rate
  • Surgery
  • Retrospective Studies
  • Rectal Neoplasms
  • Neoplasm Staging
  • Neoadjuvant Therapy
  • Middle Aged
  • Male
 

Citation

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Cox, M. L., Adam, M. A., Shenoi, M. M., Turner, M. C., Sun, Z., Mantyh, C. R., & Migaly, J. (2018). Resected irradiated rectal cancers: Are twelve lymph nodes really necessary in the era of neoadjuvant therapy? In Am J Surg (Vol. 216, pp. 444–449). United States. https://doi.org/10.1016/j.amjsurg.2017.08.014
Cox, Morgan L., Mohamed A. Adam, Mithun M. Shenoi, Megan C. Turner, Zhifei Sun, Christopher R. Mantyh, and John Migaly. “Resected irradiated rectal cancers: Are twelve lymph nodes really necessary in the era of neoadjuvant therapy?” In Am J Surg, 216:444–49, 2018. https://doi.org/10.1016/j.amjsurg.2017.08.014.
Cox ML, Adam MA, Shenoi MM, Turner MC, Sun Z, Mantyh CR, et al. Resected irradiated rectal cancers: Are twelve lymph nodes really necessary in the era of neoadjuvant therapy? In: Am J Surg. 2018. p. 444–9.
Cox, Morgan L., et al. “Resected irradiated rectal cancers: Are twelve lymph nodes really necessary in the era of neoadjuvant therapy?Am J Surg, vol. 216, no. 3, 2018, pp. 444–49. Pubmed, doi:10.1016/j.amjsurg.2017.08.014.
Cox ML, Adam MA, Shenoi MM, Turner MC, Sun Z, Mantyh CR, Migaly J. Resected irradiated rectal cancers: Are twelve lymph nodes really necessary in the era of neoadjuvant therapy? Am J Surg. 2018. p. 444–449.
Journal cover image

Published In

Am J Surg

DOI

EISSN

1879-1883

Publication Date

September 2018

Volume

216

Issue

3

Start / End Page

444 / 449

Location

United States

Related Subject Headings

  • United States
  • Time Factors
  • Survival Rate
  • Surgery
  • Retrospective Studies
  • Rectal Neoplasms
  • Neoplasm Staging
  • Neoadjuvant Therapy
  • Middle Aged
  • Male