Prognostic importance of lymph node count and ratio in rectal cancer after neoadjuvant chemoradiotherapy: Results from a cross-sectional study

Dutch Snapshot Research Group; Robin Detering; Vincent M. Meyer; Pieter Tanis; Henderik L. van Westreenen

doi:10.1002/jso.26522

Prognostic importance of lymph node count and ratio in rectal cancer after neoadjuvant chemoradiotherapy: Results from a cross-sectional study

Dutch Snapshot Research Group
, Robin Detering
, Vincent M. Meyer^*
, Pieter Tanis
, Henderik L. van Westreenen

^*Corresponding author for this work

VU University Medical Center
Onze Lieve Vrouwe Gasthuis
University of Amsterdam
Amsterdam UMC
Dutch Institute for Clinical Auditing (DICA)
Isala Clinics
Department of Cardiothoracic Surgery
Department of Orthopaedic Surgery
Department of Surgery
St. Antonius Ziekenhuis

Research output: Contribution to journal › Article › Academic › peer-review

7 Citations (Scopus)

Abstract

BACKGROUND:

The aim of this study was to determine the prognostic value of lymph node count (LNC) and lymph node ratio (LNR) in rectal cancer after neoadjuvant chemoradiotherapy (CRT).

METHODS:

Patients who underwent neoadjuvant CRT and total mesorectal excision (TME) for Stage I-III rectal cancer were selected from a cross-sectional study including 71 Dutch centres. Primary outcome parameters were disease-free survival (DFS) and overall survival (OS). Prognostic significance of LNC and LNR (cut-off values 0.15, 0.20, 0.30) was tested for different (sub)groups.

RESULTS:

From 2095 registered patients, 458 were included, of which 240 patients with LNC < 12 and 218 patients with LNC ≥ 12. LNC was not significantly associated with DFS (p = 0.35) and OS (p = 0.59). In univariable analysis, LNR was significantly associated with DFS and OS in the whole cohort and LNC subgroups, but not in multivariable analysis.

CONCLUSIONS:

LNC was not associated with long-term oncological outcome in rectal cancer patients treated with CRT, nor was LNR when corrected for N-stage. However, LNR might be used to identify subgroups of node-positive patients with a favourable outcome.

Original language	English
Pages (from-to)	367-377
Number of pages	11
Journal	Journal of Surgical Oncology
Volume	124
Issue number	3
DOIs	https://doi.org/10.1002/jso.26522 https://doi.org/10.1002/jso.26522
Publication status	Published - 1 Sept 2021

Bibliographical note

Publisher Copyright:
© 2021 Wiley Periodicals LLC

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@article{e91a4afe73ca40e9a77342669e5733a8,

title = "Prognostic importance of lymph node count and ratio in rectal cancer after neoadjuvant chemoradiotherapy: Results from a cross-sectional study",

abstract = "BACKGROUND: The aim of this study was to determine the prognostic value of lymph node count (LNC) and lymph node ratio (LNR) in rectal cancer after neoadjuvant chemoradiotherapy (CRT).METHODS: Patients who underwent neoadjuvant CRT and total mesorectal excision (TME) for Stage I-III rectal cancer were selected from a cross-sectional study including 71 Dutch centres. Primary outcome parameters were disease-free survival (DFS) and overall survival (OS). Prognostic significance of LNC and LNR (cut-off values 0.15, 0.20, 0.30) was tested for different (sub)groups.RESULTS:From 2095 registered patients, 458 were included, of which 240 patients with LNC < 12 and 218 patients with LNC ≥ 12. LNC was not significantly associated with DFS (p = 0.35) and OS (p = 0.59). In univariable analysis, LNR was significantly associated with DFS and OS in the whole cohort and LNC subgroups, but not in multivariable analysis.CONCLUSIONS: LNC was not associated with long-term oncological outcome in rectal cancer patients treated with CRT, nor was LNR when corrected for N-stage. However, LNR might be used to identify subgroups of node-positive patients with a favourable outcome.",

author = "\{Dutch Snapshot Research Group\} and Tanis, \{Pieter J.\} and A. Brandt-Kerkhof and Brinkman, \{D. J.\} and Burger, \{J. W.A.\} and Coene, \{P. P.L.O.\} and \{de Graaf\}, \{E. J.R.\} and \{de Vos tot Nederveen Cappel\}, \{R. J.\} and Dekker, \{J. W.T.\} and A. Demirkiran and F. Ferenschild and \{Van Grevenstein\}, \{W. M.U.\} and R. Haen and C. Hoff and W. Hogendoorn and E. Madsen and Menon, \{A. G.\} and Musters, \{G. D.\} and J. Nonner and Oosterling, \{S. J.\} and Slooter, \{G. D.\} and \{Spillenaar Bilgen\}, \{E. J.\} and L. Tseng and \{van der Hul\}, R. and \{van der Schelling\}, G. and \{van Essen\}, \{J. A.\} and Vles, \{W. J.\} and Vrijland, \{W. W.\} and Witjes, \{C. D.M.\} and Zeestraten, \{E. C.\} and Zimmerman, \{D. D.E.\} and Robin Detering and Meyer, \{Vincent M.\} and Pieter Tanis and \{van Westreenen\}, \{Henderik L.\}",

note = "Publisher Copyright: {\textcopyright} 2021 Wiley Periodicals LLC",

year = "2021",

month = sep,

day = "1",

doi = "10.1002/jso.26522",

language = "English",

volume = "124",

pages = "367--377",

number = "3",

}

Prognostic importance of lymph node count and ratio in rectal cancer after neoadjuvant chemoradiotherapy: Results from a cross-sectional study. / Dutch Snapshot Research Group; Detering, Robin; Meyer, Vincent M. et al.
In: Journal of Surgical Oncology, Vol. 124, No. 3, 01.09.2021, p. 367-377.

Research output: Contribution to journal › Article › Academic › peer-review

TY - JOUR

T1 - Prognostic importance of lymph node count and ratio in rectal cancer after neoadjuvant chemoradiotherapy

T2 - Results from a cross-sectional study

AU - Dutch Snapshot Research Group

AU - Tanis, Pieter J.

AU - Brandt-Kerkhof, A.

AU - Brinkman, D. J.

AU - Burger, J. W.A.

AU - Coene, P. P.L.O.

AU - de Graaf, E. J.R.

AU - de Vos tot Nederveen Cappel, R. J.

AU - Dekker, J. W.T.

AU - Demirkiran, A.

AU - Ferenschild, F.

AU - Van Grevenstein, W. M.U.

AU - Haen, R.

AU - Hoff, C.

AU - Hogendoorn, W.

AU - Madsen, E.

AU - Menon, A. G.

AU - Musters, G. D.

AU - Nonner, J.

AU - Oosterling, S. J.

AU - Slooter, G. D.

AU - Spillenaar Bilgen, E. J.

AU - Tseng, L.

AU - van der Hul, R.

AU - van der Schelling, G.

AU - van Essen, J. A.

AU - Vles, W. J.

AU - Vrijland, W. W.

AU - Witjes, C. D.M.

AU - Zeestraten, E. C.

AU - Zimmerman, D. D.E.

AU - Detering, Robin

AU - Meyer, Vincent M.

AU - Tanis, Pieter

AU - van Westreenen, Henderik L.

PY - 2021/9/1

Y1 - 2021/9/1

N2 - BACKGROUND: The aim of this study was to determine the prognostic value of lymph node count (LNC) and lymph node ratio (LNR) in rectal cancer after neoadjuvant chemoradiotherapy (CRT).METHODS: Patients who underwent neoadjuvant CRT and total mesorectal excision (TME) for Stage I-III rectal cancer were selected from a cross-sectional study including 71 Dutch centres. Primary outcome parameters were disease-free survival (DFS) and overall survival (OS). Prognostic significance of LNC and LNR (cut-off values 0.15, 0.20, 0.30) was tested for different (sub)groups.RESULTS:From 2095 registered patients, 458 were included, of which 240 patients with LNC < 12 and 218 patients with LNC ≥ 12. LNC was not significantly associated with DFS (p = 0.35) and OS (p = 0.59). In univariable analysis, LNR was significantly associated with DFS and OS in the whole cohort and LNC subgroups, but not in multivariable analysis.CONCLUSIONS: LNC was not associated with long-term oncological outcome in rectal cancer patients treated with CRT, nor was LNR when corrected for N-stage. However, LNR might be used to identify subgroups of node-positive patients with a favourable outcome.

AB - BACKGROUND: The aim of this study was to determine the prognostic value of lymph node count (LNC) and lymph node ratio (LNR) in rectal cancer after neoadjuvant chemoradiotherapy (CRT).METHODS: Patients who underwent neoadjuvant CRT and total mesorectal excision (TME) for Stage I-III rectal cancer were selected from a cross-sectional study including 71 Dutch centres. Primary outcome parameters were disease-free survival (DFS) and overall survival (OS). Prognostic significance of LNC and LNR (cut-off values 0.15, 0.20, 0.30) was tested for different (sub)groups.RESULTS:From 2095 registered patients, 458 were included, of which 240 patients with LNC < 12 and 218 patients with LNC ≥ 12. LNC was not significantly associated with DFS (p = 0.35) and OS (p = 0.59). In univariable analysis, LNR was significantly associated with DFS and OS in the whole cohort and LNC subgroups, but not in multivariable analysis.CONCLUSIONS: LNC was not associated with long-term oncological outcome in rectal cancer patients treated with CRT, nor was LNR when corrected for N-stage. However, LNR might be used to identify subgroups of node-positive patients with a favourable outcome.

UR - https://www.scopus.com/pages/publications/85105721092

U2 - 10.1002/jso.26522

DO - 10.1002/jso.26522

M3 - Article

C2 - 33988882

AN - SCOPUS:85105721092

SN - 0022-4790

VL - 124

SP - 367

EP - 377

JO - Journal of Surgical Oncology

JF - Journal of Surgical Oncology

IS - 3

ER -

Prognostic importance of lymph node count and ratio in rectal cancer after neoadjuvant chemoradiotherapy: Results from a cross-sectional study

Abstract

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