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Is T classification still correlated with lymph node status after preoperative chemoradiotherapy for rectal cancer?
Version of Record online: 10 MAR 2006
Copyright © 2006 American Cancer Society
Volume 106, Issue 8, pages 1694–1700, 15 April 2006
How to Cite
Kim, D.-W., Kim, D. Y., Kim, T. H., Jung, K. H., Chang, H. J., KyungSohn, D., Lim, S.-B., Choi, H. S., Jeong, S.-y. and Park, J.-G. (2006), Is T classification still correlated with lymph node status after preoperative chemoradiotherapy for rectal cancer?. Cancer, 106: 1694–1700. doi: 10.1002/cncr.21794
- Issue online: 4 APR 2006
- Version of Record online: 10 MAR 2006
- Manuscript Accepted: 7 NOV 2005
- Manuscript Revised: 12 OCT 2005
- Manuscript Received: 10 AUG 2005
- Korea Health 21 R&D Project, Ministry of Health and Welfare, Republic of Korea. Grant Number: 0412-CR01-0704-0001
- lymph node status;
- T classification;
- preoperative chemoradiotherapy;
- rectal cancer
It is well known that the risk of lymph node involvement increases according to pathologic T classification in rectal cancers, but to the authors' knowledge, the correlation between risk of lymph node involvement and ypT classification in rectal cancers treated with preoperative chemoradiotherapy (CRT) remains unclear. The current study investigated the correlation between tumor involvement in regional lymph nodes and rectal mural tumor status in patients who underwent preoperative CRT for rectal cancer.
Between October 2001 and February 2005, 282 patients underwent preoperative CRT followed by proctectomy for locally advanced rectal adenocarcinoma. Correlations between lymph node status and ypT classification, Dworak regression grade, and magnetic resonance (MR) volumetry findings were explored.
Lymph nodes harboring tumors were found in 87 of 282 (30.9%) patients. The rate of lymph node involvement was found to be correlated with ypT-classification (P < .001); positive lymph nodes were detected in 1 of 45 (2.2%) ypT0 patients, 1 of 13 (7.7%) ypT1 patients, 13 of 77 (16.9%) ypT2 patients, 69 of 140 (49.3%) ypT3 patients, and 3 of 7 (42.9%) ypT4 patients. The rate of lymph node involvement decreased as Dworak regression grade increased (P < .001); tumor-harboring lymph nodes were found in 62.3% of Grade 1 patients, 31.4% of Grade 2 patients, 16.1% of Grade 3 patients, and 2.2% of Grade 4 patients. There were no differences noted with regard to MR volumetry findings, including mean volume of pre- or post-CRT tumor and the tumor volume reduction rate between lymph node-negative and lymph node-positive patients.
Pathologic T classification is still the most reliable predictor of lymph node metastasis in rectal cancer patients who have undergone preoperative CRT. The risk of lymph node metastasis was found to be 3.4% in rectal cancer that had regressed to ypT0 or ypT1. Cancer 2006. © 2006 American Cancer Society.