Lymph Node Harvest in Rectal Cancer Surgery Following Neoadjuvant Chemoradiotherapy
Journal of Surgery
Volume 2, Issue 2, April 2014, Pages: 27-31
Received: Mar. 8, 2014;
Accepted: Apr. 8, 2014;
Published: Apr. 10, 2014
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Kolitha Goonetilleke, Walsall Health Care NHS Trust, Moat Road, Walsall, West Midlands, WS2 9PS, United Kingdom
Rob Church, Walsall Health Care NHS Trust, Moat Road, Walsall, West Midlands, WS2 9PS, United Kingdom
Sarah Addison, Walsall Health Care NHS Trust, Moat Road, Walsall, West Midlands, WS2 9PS, United Kingdom
Steve Odogwu, Walsall Health Care NHS Trust, Moat Road, Walsall, West Midlands, WS2 9PS, United Kingdom
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.
Lymph Node Harvest in Rectal Cancer Surgery Following Neoadjuvant Chemoradiotherapy, Journal of Surgery.
Vol. 2, No. 2,
2014, pp. 27-31.
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