Mei SW, Liu Z, Wang Z, Pei W, Wei FZ, Chen JN, Wang ZJ, Shen HY, Li J, Zhao FQ, Wang XS, Liu Q. Impact factors of lymph node retrieval on survival in locally advanced rectal cancer with neoadjuvant therapy. World J Clin Cases 2020; 8(24): 6229-6242 [PMID: 33392304 DOI: 10.12998/wjcc.v8.i24.6229]
Corresponding Author of This Article
Qian Liu, MD, Chief Doctor, Department of Colorectal Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No. 17 Panjiayuan Nanli, Chaoyang District, Beijing 100021, China. fcwpumch@163.com
Research Domain of This Article
Oncology
Article-Type of This Article
Retrospective Cohort Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Shi-Wen Mei, Zheng Liu, Zheng Wang, Wei Pei, Fang-Ze Wei, Jia-Nan Chen, Zhi-Jie Wang, Hai-Yu Shen, Juan Li, Fu-Qiang Zhao, Xi-Shan Wang, Qian Liu, Department of Colorectal Surgery, National Cancer Center/National Clinical Research Center for Cancer/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
Author contributions: Mei SW, Chen JN and Wang ZJ designed the research; Wei FZ, Shen HY, Li J and Zhao FQ collected the data; Pei W, Wang Z, Liu Z and Wei FZ analyzed the data; Mei SW drafted the manuscript; Liu Q and Wang XS revised the paper.
Supported byNational Key Research and Development Plan "Research on Prevention and Control of Major Chronic Non-Communicable Diseases", No. 2019YFC1315705; and The Medicine and Health Technology Innovation Project of Chinese Academy of Medical Sciences, No. 2017-12M-1-006.
Institutional review board statement: The study received approval from the ethics committee of the National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College (Approval No. 17-116/1439).
Informed consent statement: All study participants, or their legal guardian, provided informed written consent prior to study enrollment.
Conflict-of-interest statement: The authors declare there is no conflict of interest in regard to this research.
Data sharing statement: No additional data are available.
STROBE statement: The authors have read the STROBE Statement-checklist of items, and the manuscript was prepared and revised according to the STROBE Statement-checklist of items.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Qian Liu, MD, Chief Doctor, Department of Colorectal Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No. 17 Panjiayuan Nanli, Chaoyang District, Beijing 100021, China. fcwpumch@163.com
Received: August 23, 2020 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
ARTICLE HIGHLIGHTS
Research background
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.
Research motivation
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.
Research objectives
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.
Research methods
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.
Research results
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.
Research conclusions
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.
Research perspectives
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.
