This is the Scientific Surgery Archive, which contains all randomized clinical trials in surgery that have been identified by searching the top 50 English language medical journal issues since January 1998. Compiled by Jonothan J. Earnshaw, former Editor-in-Chief, BJS
Prognostic value of pathological node status after neoadjuvant radiotherapy for rectal cancer. BJS 2018; 105: 1501-1509.
Published: 17th April 2018
Authors: E. Duchalais, T. Glyn Mullaney, G. M. Spears, S. R. Kelley, K. Mathis, W. S. Harmsen et al.
Background
The prognostic value of pathological lymph node status following neoadjuvant radiotherapy (ypN) remains unclear. This study was designed to determine whether ypN status predicted overall survival.
Method
Patients with locally advanced rectal adenocarcinoma who underwent neoadjuvant long‐course radiation between 2005 and 2014 were identified from the National Cancer Data Base, and divided into ypN0, ypN1 and ypN2 groups. The primary outcome was overall survival. Univariable and multivariable analyses were used to determine factors associated with overall survival.
Results
Of 12 271 patients, 3713 (30·3 per cent) were found to have residual nodal positivity. A majority of patients with ypN1 (1663 of 2562) and ypN2 (878 of 1151) disease had suspected lymph node‐positive disease before neoadjuvant therapy, compared with 3959 of 8558 with ypN0 tumours (
Conclusion
Both ypT and ypN status is of prognostic significance following neoadjuvant therapy for rectal cancer.
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