期刊
ONCOLOGY
卷 96, 期 1, 页码 33-43出版社
KARGER
DOI: 10.1159/000492493
关键词
Rectal cancer; Lateral pelvic lymph node; Chemoradiotherapy; Lung metastasis; Liver metastasis
类别
资金
- Japan Society for the Promotion of Science [16K07143, 16K07161, 17K10620, 17K10621, 17K10623, 18K07194]
- Project for Cancer Research and Therapeutic Evolution (P-CREATE) from the Japan Agency for Medical Research and Development (AMED) [18cm0106502h0003]
Objective: Factors that predict rectal cancer metastasis to the lungs remain undefined. We investigated whether the lateral pelvic lymph node (LPN) sizes before and after chemoradiotherapy (CRT) correlate with lung metastasis after surgery for lower rectal cancer. Methods: Two hundred and forty patients with lower rectal cancer who received preoperative CRT and curative surgery between 2003 and 2017 were examined. Computed tomography-measured LPN sizes before and after CRT were retrospectively determined by 1 colorectal surgeon who was blinded to the patients' clinical and pathological outcomes. Results: The 5-year cumulative lung metastasis rates were 15.2%. The mean LPN sizes in patients who developed lung metastasis were larger than those in patients who did not (pre-CRT: 8.7 vs. 6.3 mm, p = 0.003; post-CRT: 6.8 vs. 4.5 mm, p = 0.001). The cumulative lung metastasis rate in patients with large LPNs was higher than in those with small LPNs both before and after CRT. On multivariate analysis, lung metastasis was independently correlated with the LPN size only after CRT (hazard ratio [HR]: 5.58), together with the ypT stage (HR: 2.96) and the tumor location (HR: 0.38). Conclusions: LPN size after CRT is strongly predictive of postoperative lung metastasis in patients with lower rectal cancer. (C) 2018 S. Karger AG, Basel
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