The authors declare that there exist neither potential nor actual conflicts of interest.
Prognostic significance of distribution of lymph node metastasis in advanced mid or low rectal cancer†
Article first published online: 2 MAY 2011
Copyright © 2011 Wiley-Liss, Inc.
Journal of Surgical Oncology
Volume 104, Issue 5, pages 486–492, 1 October 2011
How to Cite
Kim, J. S., Sohn, D. K., Park, J. W., Kim, D. Y., Chang, H. J., Choi, H. S. and Oh, J. H. (2011), Prognostic significance of distribution of lymph node metastasis in advanced mid or low rectal cancer. J. Surg. Oncol., 104: 486–492. doi: 10.1002/jso.21966
- Issue published online: 6 SEP 2011
- Article first published online: 2 MAY 2011
- Manuscript Accepted: 5 APR 2011
- Manuscript Received: 1 JUL 2010
- National Cancer Center of Korea. Grant Number: 0910520
- rectal neoplasm;
- lymph node;
Few studies have focused on distribution of lymph node metastasis. The aim of this study is to evaluate the prognostic significance of the location of involved lymph nodes in patients with advanced mid or low rectal cancer.
We defined proximal lymph node involvement (PLNp) as superior rectal and inferior mesenteric lymph node metastasis along the trunks of the supplying vessel, and mesorectal lymph node involvement (MLNp) as lymph node metastasis located within the mesorectum.
PLNp was identified in 67 patients (8.4%) of total 797 patients. Age <60 years (P = 0.02), poorly differentiated/mucinous histologic type (P = 0.011), and positive perineural invasion (P < 0.001) were risk factors of PLNp in patients with node positive rectal cancer. Patients with PLNp had poorer oncologic outcomes than those without PLNp in terms of overall survival (P < 0.001). For patients with node-positive rectal cancer, there was significant difference in the overall survival rate between PLNp and MLNp groups, regardless of N stage (P = 0.025 for N1, P = 0.009 for N2).
Our results suggest that PLNp is associated with adverse oncologic outcomes and has prognostic significance in patients with node positive mid or low rectal cancer. J. Surg. Oncol. 2011; 104:486–492. © 2011 Wiley-Liss, Inc.