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Medicina is published by MDPI from Volume 54 Issue 1 (2018). Articles in this Issue were published by another publisher in Open Access under a CC-BY (or CC-BY-NC-ND) licence. Articles are hosted by MDPI on mdpi.com as a courtesy and upon agreement with Lithuanian Medical Association, Lithuanian University of Health Sciences, and Vilnius University.
Open AccessArticle

Lymph node retrieval after resection of rectal cancer following preoperative chemoradiotherapy

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Department of Surgery, Kaunas University of Medicine
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Department of Oncology, Kaunas University of Medicine
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Department of Pathology, Kaunas University of Medicine, Lithuania
*
Author to whom correspondence should be addressed.
Medicina 2010, 46(5), 299; https://doi.org/10.3390/medicina46050042
Received: 10 November 2009 / Accepted: 7 May 2010 / Published: 12 May 2010
Background. According to the current guidelines of proper TNM staging, 12 lymph nodes per specimen are crucial. This study assessed the role of preoperative radiochemotherapy on the number of lymph nodes detected in the tumor-bearing specimen.
Material and methods. Retrospective data of 138 patients who underwent surgery for stage II and III rectal cancer without preoperative radiochemotherapy during the period of 2004–2006 (control group) were compared with prospective data of 38 patients who received preoperative radiochemotherapy during the period of 2007–2008 (study group). The number of patients with metastatic lymph nodes, number of lymph nodes per specimen, number of metastatic lymph nodes per specimen, and the size of the tumor between the groups were compared.
Results. Positive lymph nodes were detected in 88 (64%) patients in the control group as compared with 9 (21%) patients in the study group (P<0.05). The mean number of lymph nodes per specimen in the control group was 13.5, while in the study group, the mean number of lymph nodes per specimen was 6.29 (P<0.05). There was a significant difference in the mean number of metastatic lymph nodes per specimen between the groups (5.12 in the control group versus 2.11 in the study group; P<0.05). The mean size of the tumor was 4.37 cm in the control group and 2.45 cm in the study group (P<0.01).
Conclusions
. Preoperative radiochemotherapy for advanced rectal cancer significantly decreased the number of lymph nodes detected in the tumor-bearing specimen. This also resulted in a significant decrease in the number of metastatic lymph nodes detected in the specimen, and fewer patients with stage III (N+) cancer were diagnosed. Preoperative radiochemotherapy could induce a significant downsizing and downstaging of advanced rectal cancer, but great care in operative and pathologic examination techniques must be taken to ensure appropriate staging.
Keywords: rectal cancer; preoperative chemoradiotherapy rectal cancer; preoperative chemoradiotherapy
MDPI and ACS Style

Latkauskas, T.; Lizdenis, P.; Jančiauskienė, R.; Pranys, D.; Tamelis, A.; Pavalkis, D. Lymph node retrieval after resection of rectal cancer following preoperative chemoradiotherapy. Medicina 2010, 46, 299.

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