Journal of Surgery

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Lymph Node Harvest in Rectal Cancer Surgery Following Neoadjuvant Chemoradiotherapy

Received: 08 March 2014    Accepted: 08 April 2014    Published: 10 April 2014
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Abstract

Purpose: The purpose of the study is to investigate the effect of neoadjuvant chemoradiation, as well as clinicopathological features, on the yield of lymph nodes and survival in rectal carcinoma. Methods: We conducted a retrospective cohort study using an institutional database. 93 patients with rectal cancer treated with curative surgery from 2009 through 2012 at a single District General Hospital in the United Kingdom were included in the study. Follow up perioed was 4 years. Patients had neoadjuvant long course chemoradiotherapy if they were stage II or III. Results: A total of 93 patients were included. 51 received neoadjuvant therapy (NEO) before resection and 42 proceeded to surgery (SURG). There was less lymph node yield in patients who received neoadjuvant therapy (21 vs. 16, p < 0.05). Examination of pathology reports revealed that all patients in the NEO group had more nodes with metastatic disease compared to the SURG group (23 vs 18, p<0.05). The sphincter preservation rate was 83% for patients operated with neoadjuvant treatment versus 95 % for those in surgery group, Patients within the neoadjuvant group had a statistically significant higher number of APR (NEO 17% vs. SURG 5% vs. p<0.01). There was no survival advantage in the neoadjuvant group. Conclusion: Preoperative CRT is associated with a reduction in the yield of lymph nodes in rectal cancer surgery. This is mainly related to radiotherapy, which exerts its effects on the lymph nodes. Also factors such as sex and the level of the tumour may affect lymph node yield.

DOI 10.11648/j.js.20140202.13
Published in Journal of Surgery (Volume 2, Issue 2, April 2014)
Page(s) 27-31
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2024. Published by Science Publishing Group

Keywords

Lymph Nodes, Neoadjuvant Therapy, Rectal Cancer, Survival

References
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Author Information
  • Walsall Health Care NHS Trust, Moat Road, Walsall, West Midlands, WS2 9PS, United Kingdom

  • Walsall Health Care NHS Trust, Moat Road, Walsall, West Midlands, WS2 9PS, United Kingdom

  • Walsall Health Care NHS Trust, Moat Road, Walsall, West Midlands, WS2 9PS, United Kingdom

  • Walsall Health Care NHS Trust, Moat Road, Walsall, West Midlands, WS2 9PS, United Kingdom

Cite This Article
  • APA Style

    Kolitha Goonetilleke, Rob Church, Sarah Addison, Steve Odogwu. (2014). Lymph Node Harvest in Rectal Cancer Surgery Following Neoadjuvant Chemoradiotherapy. Journal of Surgery, 2(2), 27-31. https://doi.org/10.11648/j.js.20140202.13

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    ACS Style

    Kolitha Goonetilleke; Rob Church; Sarah Addison; Steve Odogwu. Lymph Node Harvest in Rectal Cancer Surgery Following Neoadjuvant Chemoradiotherapy. J. Surg. 2014, 2(2), 27-31. doi: 10.11648/j.js.20140202.13

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    AMA Style

    Kolitha Goonetilleke, Rob Church, Sarah Addison, Steve Odogwu. Lymph Node Harvest in Rectal Cancer Surgery Following Neoadjuvant Chemoradiotherapy. J Surg. 2014;2(2):27-31. doi: 10.11648/j.js.20140202.13

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  • @article{10.11648/j.js.20140202.13,
      author = {Kolitha Goonetilleke and Rob Church and Sarah Addison and Steve Odogwu},
      title = {Lymph Node Harvest in Rectal Cancer Surgery Following Neoadjuvant Chemoradiotherapy},
      journal = {Journal of Surgery},
      volume = {2},
      number = {2},
      pages = {27-31},
      doi = {10.11648/j.js.20140202.13},
      url = {https://doi.org/10.11648/j.js.20140202.13},
      eprint = {https://download.sciencepg.com/pdf/10.11648.j.js.20140202.13},
      abstract = {Purpose: The purpose of the study is to investigate the effect of neoadjuvant chemoradiation, as well as clinicopathological features, on the yield of lymph nodes and survival in rectal carcinoma. Methods: We conducted a retrospective cohort study using an institutional database. 93 patients with rectal cancer treated with curative surgery from 2009 through 2012 at a single District General Hospital in the United Kingdom were included in the study. Follow up perioed was 4 years. Patients had neoadjuvant long course chemoradiotherapy if they were stage II or III. Results: A total of 93 patients were included. 51 received neoadjuvant therapy (NEO) before resection and 42 proceeded to surgery (SURG). There was less lymph node yield in patients who received neoadjuvant therapy (21 vs. 16, p < 0.05). Examination of pathology reports revealed that all patients in the NEO group had more nodes with metastatic disease compared to the SURG group (23 vs 18, p<0.05). The sphincter preservation rate was 83% for patients operated with neoadjuvant treatment versus 95 % for those in surgery group, Patients within the neoadjuvant group had a statistically significant higher number of APR (NEO 17% vs. SURG 5% vs. p<0.01). There was no survival advantage in the neoadjuvant group. Conclusion: Preoperative CRT is associated with a reduction in the yield of lymph nodes in rectal cancer surgery. This is mainly related to radiotherapy, which exerts its effects on the lymph nodes. Also factors such as sex and the level of the tumour may affect lymph node yield.},
     year = {2014}
    }
    

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  • TY  - JOUR
    T1  - Lymph Node Harvest in Rectal Cancer Surgery Following Neoadjuvant Chemoradiotherapy
    AU  - Kolitha Goonetilleke
    AU  - Rob Church
    AU  - Sarah Addison
    AU  - Steve Odogwu
    Y1  - 2014/04/10
    PY  - 2014
    N1  - https://doi.org/10.11648/j.js.20140202.13
    DO  - 10.11648/j.js.20140202.13
    T2  - Journal of Surgery
    JF  - Journal of Surgery
    JO  - Journal of Surgery
    SP  - 27
    EP  - 31
    PB  - Science Publishing Group
    SN  - 2330-0930
    UR  - https://doi.org/10.11648/j.js.20140202.13
    AB  - Purpose: The purpose of the study is to investigate the effect of neoadjuvant chemoradiation, as well as clinicopathological features, on the yield of lymph nodes and survival in rectal carcinoma. Methods: We conducted a retrospective cohort study using an institutional database. 93 patients with rectal cancer treated with curative surgery from 2009 through 2012 at a single District General Hospital in the United Kingdom were included in the study. Follow up perioed was 4 years. Patients had neoadjuvant long course chemoradiotherapy if they were stage II or III. Results: A total of 93 patients were included. 51 received neoadjuvant therapy (NEO) before resection and 42 proceeded to surgery (SURG). There was less lymph node yield in patients who received neoadjuvant therapy (21 vs. 16, p < 0.05). Examination of pathology reports revealed that all patients in the NEO group had more nodes with metastatic disease compared to the SURG group (23 vs 18, p<0.05). The sphincter preservation rate was 83% for patients operated with neoadjuvant treatment versus 95 % for those in surgery group, Patients within the neoadjuvant group had a statistically significant higher number of APR (NEO 17% vs. SURG 5% vs. p<0.01). There was no survival advantage in the neoadjuvant group. Conclusion: Preoperative CRT is associated with a reduction in the yield of lymph nodes in rectal cancer surgery. This is mainly related to radiotherapy, which exerts its effects on the lymph nodes. Also factors such as sex and the level of the tumour may affect lymph node yield.
    VL  - 2
    IS  - 2
    ER  - 

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