Prognostic impact of at least 12 lymph nodes after neoadjuvant therapy in rectal cancer: A meta-analysis

Table 1 Characteristics of studies included in the meta-analysis

Ref.	Country	n	Age (yr)	Stage	Treatment	Surgery	Year of follow-up	Outcome
Wang et al[17], 2019	China	495	< 50: 160; > 50: 335	I-IV	Neoadjuvant treatment (RT 45-55 Gy + capecitabine)	AR, APR, Hartmann	No report	OS, DFS, LR, DR
Lykke et al[18], 2015	Denmark	2123	60-75	I-IV	Neoadjuvant treatment	TME	No report	OS
de Campos-Lobato et al[23], 2013	United States	237	57 (49-66)	II-III	Neoadjuvant treatment	LAR, APR	55 (36-77) mo	OS, DR, LR
Kim et al[20], 2015	South Korea	302	39-73	I-IV	Neoadjuvant treatment (IV 5-FU leucovorin or oral 5-FU based)	LAR, APR, CAA	57 mo	OS, DFS
Doll et al[22], 2009	Germany	102	18-75	I-IV	Neoadjuvant diochemotherapy (RT 45 Gy + 5-FU)	(L)AR, Miles	No reports	OS
La Torre et al[19], 2013	Italy	123	67.9 (27-91)	I-IV	Neoadjuvant diochemotherapy (RT 45 Gy + 5-FU)	LAR, APR	50 (9–120) mo	OS, DFS
Kim et al[24], 2015	South Korea	433	62 ± 11.1	I-IV	Perioperative chemoradiation (45.0–50.4 Gy + 5-FU and leucovorin)	TME	41.2 mo	DFS
Han et al[21], 2016	South Korea	458	60 (22-99)	I-III	Neoadjuvant treatment (RT 45–50.4 Gy + 5-FU)	TME	52 mo	OS, DFS
Klos et al[25], 2010	United States	221	53 ± 13	-	neoadjuvant treatment (RT 45.0–50.4 Gy + 5-FU)	TME	36 (21.6-63.6) mo	LR, DR

OS: Overall survival; DFS: Disease-free survival; DR: Distant recurrence; LR: Local recurrence; RT: Radiotherapy; 5-FU: 5-Fluorouracil; TME: Total mesolectal excision; APR: Abdominoperineal resection; LAR: Low anterior resection; CAA: Coloanal anastomosis; AR: Anterior resection.

Table 2 Prognosis of different lymph node yield after neoadjuvant therapy for rectal cancer

Ref.	n	Treatment	Number of LNs compared	OS (HR or percent)	DFS (HR or percent)
Yeo et al[27], 2020	94	Neoadjuvant CRT (RT 45 Gy + capecitabine)	LNs ≥ 8.5 vs LNs < 8.5	HR: 0.31 (95%CI: 0.15-0.64, P < 0.001)	-
			LNs ≥ 16.5 vs LNs < 16.5	-	HR: 0.46 (95%CI: 0.17-1.27, P = 0.13)
La Torre et al[19], 2013	123	Neoadjuvant CRT (RT 45 Gy + 5-FU)	LNs ≥ 6 vs LNs < 6	5-yr OS: 84% vs 75% (P = 0.03)	5-yr DFS: 83% vs 75% (P = 0.03)
Tsai et al[28], 2011	372	Neoadjuvant CRT (RT 45 Gy + 5-FU and/or capecitabine)	LNs > 7 vs LNs ≤ 7	5-yr OS: 86.9% vs 81% (P = 0.067)	-
Han et al[21], 2016	458	Neoadjuvant CRT (RT 45–50.4 Gy + 5-FU)	LNs ≥ 8 vs LNs < 8	HR: 0.5 (95%CI: 0.2-0.9, P = 0.002)	HR: 0.6 (95%CI: 0.4-1.1, P = 0.042)
Pitto et al[29], 2020	104	Neoadjuvant RT (RT 45 Gy + capecitabine)	LNs: 10-20 vs LNs ≤ 9 and ≥ 20	-	HR: 0.313 (95%CI: 0.1-0.99, P = 0.049)

OS: Overall survival; DFS: Disease-free survival; LNs: Lymph nodes; HR: Hazard ratio; CRT: Chemoradiation therapy; RT: Radiotherapy; 5-FU: 5-Fuorouracil; CI: Confidence interval.