关键词: 淋巴结计数, 淋巴结转移, 预后, 直肠癌, 新辅助放化疗

Abstract: 【Abstract】〓Objective〓To investigate the effect of neoadjuvant chemoradiotherapy on the number of lymph node retrieval and removal in rectal cancer surgery. Methods〓Data for patients who underwent neoadjuvant chemoradiotherapy followed by surgery for resectable rectal cancer from 2007 to 2013 were reviewed. The primary outcomes measured were the number of lymph nodes retrieved, their status, and patient survival. Results〓Of all retrievable cases, 300 patients underwent neoadjuvant chemoradiotherapy followed by surgery, and 140 patients had surgery alone. Neoadjuvant chemoradi-otherapy decreased both the number of lymph nodes retrieved [7(1-33) versus 12.5(0-44) respectively; P<0.001] and the number of positive lymph nodes [0(0-11) versus 0(0-16); P=0.001]. After neoadjuvant chemoradiotherapy, the number of retrieved lymph nodes was inversely correlated with tumor regression, and with the interval between treatment and surgery. The 5-year overall and disease-free survival rates were 86.5 and 79.1 percent respectively. After neoadjuvant therapy, lymph node status was found to be an independent predictor of survival, whereas the number of retrieved lymph nodes did not represent a prognostic factor for either overall or disease-free survival. Conclusion〓Low lymph node count after neoadjuvant chemoradiotherapy for rectal cancer does not signify an inadequate resection or understaging, but represents an increased sensitivity to the treatment.

Key words: Rectal Cancer, Neoadjuvant chemoradiotherapy, Lymph node count, Lymph node metastasis, Prognostic