肿瘤预防与治疗2019，Vol.32Issue(9)：781-787,7.DOI:10.3969/j.issn.1674-0904.2019.09.006
局部进展期直肠癌新辅助治疗后淋巴结检出数目的影响因素分析*
Factors Influencing the Number of Retrieved Lymph Nodes after Neoadju-vant Treatment for Locally Advanced Rectal Cancer
摘要
Abstract
Objective: To explore the factors influencing the number of retrieved lymph nodes after neoadjuvant treatment in locally advanced rectal cancer and its signifi-cance. Methods: Complete data of patients underwent neoad- juvant treatment for locally advanced rectal cancer followed by radical surgery in a phase III randomized clinical trial (FOWARC study) was retrospectively analyzed. The impact of clinical, image and pathological factors on the number of lymph nodes examined was evaluated. Number of lymph nodes detected, proportion of positive lymph nodes, tumor deposits, vein tumor thrombus, perineural invasion were assessed according to different tumor regression grades ( TRG). Results: A total of 444 patients with rectal cancer who underwent neoadjuvant treatment and radical surgery were enrolled in this study. The average number of retrieved lymph nodes was 11. Results of multivariate analysis showed that age, tumor length, neoad-juvant regimens and TRG were independent factors that affect the number of lymph node examined. Among TRG 0-3 pa-tients, the median number of retrieved lymph nodes was 8, 10, 11 and 13, respectively (P=0. 001); the proportion of pos-itive lymph nodes examined was 7. 8% , 14. 7% , 21. 8% and 38. 3% , respectively (P<0. 001); and differences in propor-tion of retrieved lymph nodes (P=0. 002) and proportion of vein tumor thrombus or perineural invasion examined ( P=0. 005) were also statistically significant. Conclusion: The paucity of lymph nodes retrieved is observed in patients with rec-tal cancer after neoadjuvant treatment, especially for patients who are sensitive to neoadjuvant treatment, which does not infer poor prognostic outcomes. Further analysis of optimal lymph node counts in different TRG should be performed with survival data.关键词
局部进展期直肠癌/新辅助/肿瘤消退分级/淋巴结Key words
Locally advanced rectal cancer/Neoadjuvant treatment/Tumor regression grade/Lymph node分类
医药卫生引用本文复制引用
张剑威,蔡月,谢晓煜,胡华斌,吴泽华,凌家瑜,黎健霞,黄艳,邓艳红..局部进展期直肠癌新辅助治疗后淋巴结检出数目的影响因素分析*[J].肿瘤预防与治疗,2019,32(9):781-787,7.基金项目
广州市科技计划项目(编号:201803010073) This study was supported by Guangzhou Science and Technology Plan (NO. 201803010073) . （编号:201803010073）
