Published online Dec 26, 2020. doi: 10.12998/wjcc.v8.i24.6229
Peer-review started: August 23, 2020
First decision: October 18, 2020
Revised: October 20, 2020
Accepted: November 4, 2020
Article in press: November 4, 2020
Published online: December 26, 2020
Processing time: 118 Days and 0.7 Hours
Surgery with total mesorectal excision following neoadjuvant therapy is a standard regime for locally advanced rectal cancer. The number of lymph node retrieval and survival on surgery after neoadjuvant therapy in rectal cancer are still under debate.
There is a lack of consensus concerning the actual number of lymph node retrieval in surgery after neoadjuvant therapy. Whether less or more 12 lymph nodes should be retrieved is controversial. Data are limited regarding outcomes of different number of lymph node retrieval.
The main aim of this study is to investigate whether different number of lymph node retrieval affects the rate of pathological complete response, preoperative outcomes and survival status.
This was a retrospective cohort study to collect the data of patients after neoadjuvant therapy for locally advanced rectal cancer. According to the clinicopathological characteristics and other data, the influence of neoadjuvant therapy on the number of lymph node dissection was analyzed.
A shorter interval to surgery after neoadjuvant chemoradiotherapy for rectal cancer under indications may cause increased number of lymph nodes harvested. Tumor shrinkage and more extensive lymph node retrieval may lead to a more favorable prognosis.
The TLN may help to predict the prognosis in colorectal cancer. Neoadjuvant therapy caused a decrease in the number of lymph nodes detected, leading to inaccurate staging. The retrieval of more lymph nodes may improve the accuracy of TNM staging and result in a more favorable prognosis.
Prospective randomized trials are required to evaluate the optimal number of lymph node retrieval that is needed to achieve minimum morbidity, and minimum disease recurrence.