Annals of Coloproctology

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Original Article

Colorecal cancer

Prognostic significance of lymph node yield on oncologic outcomes according to tumor response after preoperative chemoradiotherapy in rectal cancer patients: Hyo Seon Ryu, In Ja Park, Bo Kyung Ahn, Min Young Park, Min Sung Kim, Young Il Kim, Seok-Byung Lim, Jin Cheon Kim; Ann Coloproctol. 2023;39(5):410-420. Published online April 28, 2022; DOI: https://doi.org/10.3393/ac.2022.00143.0020

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Purpose
This study aimed to evaluate the predictive value of lymph node yield (LNY) for survival outcomes according to tumor response after preoperative chemoradiotherapy (PCRT) in patients with rectal cancer.
Methods
This study was a retrospective study conducted in a tertiary center. A total of 1,240 patients with clinical stage II or III rectal cancer who underwent curative resection after PCRT between 2007 and 2016 were included. Patients were categorized into the good response group (tumor regression grade [TRG], 0–1) or poor response group (TRG, 2–3). Propensity score matching was performed for age, sex, and pathologic stage between LNY of ≥12 and LNY of <12 within tumor response group. The primary outcome was 5-year disease-free survival (DFS) and overall survival (OS).
Results
LNY and positive lymph nodes were inversely correlated with TRG. In good responders, 5-year DFS and 5-year OS of patients with LNY of <12 were better than those with LNY of ≥12, but there was no statistical significance. In poor responders, the LNY of <12 group had worse survival outcomes than the LNY of ≥12 group, but there was also no statistical significance. LNY of ≥12 was not associated with DFS and OS in multivariate analysis.
Conclusion
LNY of <12 showed contrasting outcomes between the good and poor responders in 5-year DFS and OS. LNY of 12 may not imply adequate oncologic surgery or proper staging in rectal cancer patients treated by PCRT. Furthermore, a decrease in LNY should be comprehended differently according to tumor response.

Citations

Citations to this article as recorded by

Breaking Myths: Comparable Outcomes in Lymph Node Analysis Across Surgical Methods
Salvatore Pezzino, Tonia Luca, Mariacarla Castorina, Giulia Fuccio Sanzà, Gaetano Magro, Stefano Puleo, Ornella Coco, Sergio Castorina
Cancers.2025; 17(8): 1312. CrossRef
A predictive nomogram for assessing the likelihood of retrieving 12 lymph nodes after rectal cancer surgery: a single-center study
Jian Ma, Runyang Hao, Shuai Jiao, Qingmin Chen, Baohong Yang, Xu Guan, Jiale Li, Xinxuan Zhao, Yu Huo, Qingxia Xu, Haiyi Liu, Wen Su, Xishan Wang
Frontiers in Oncology.2025;[Epub] CrossRef
Effects of Adjuvant Chemotherapy on Oncologic Outcomes in Patients With Stage ⅡA Rectal Cancer Above the Peritoneal Reflection Who Did Not Undergo Preoperative Chemoradiotherapy
Hyo Seon Ryu, Jong Lyul Lee, Chan Wook Kim, Yong Sik Yoon, In Ja Park, Seok-Byung Lim, Yong Sang Hong, Tae Won Kim, Chang Sik Yu
Clinical Colorectal Cancer.2024; 23(4): 392. CrossRef
Artificial Intelligence-Driven Volumetric Analysis of Muscle Mass as a Predictor of Tumor Response to Neoadjuvant Chemoradiotherapy in Patients with Rectal Cancer
Minsung Kim, Sang Min Lee, Il Tae Son, Jaewoong Kang, Gyoung Tae Noh, Bo Young Oh
Journal of Clinical Medicine.2024; 13(23): 7018. CrossRef
Multidisciplinary Treatment Strategy for Early Colon Cancer: A Review-An English Version
Gyung Mo Son, Su Bum Park, Tae Un Kim, Byung-Soo Park, In Young Lee, Joo-Young Na, Dong Hoon Shin, Sang Bo Oh, Sung Hwan Cho, Hyun Sung Kim, Hyung Wook Kim
Journal of the Anus, Rectum and Colon.2022; 6(4): 203. CrossRef

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