Clinical Significance of Extramural Tumor Deposits in the Lateral Pelvic Lymph Node Area in Low Rectal Cancer: A Retrospective Study at Two Institutions

Ryoma Yagi, Yoshifumi Shimada, Hitoshi Kameyama, Yosuke Tajima, Takuma Okamura, Jun Sakata, Takashi Kobayashi, Shin ichi Kosugi, Toshifumi Wakai, Hitoshi Nogami, Satoshi Maruyama, Yasumasa Takii, Takashi Kawasaki, Kei ichi Honma

Research output: Contribution to journalArticlepeer-review

7 Citations (Scopus)

Abstract

Background: The presence of extramural tumor deposits without lymph node structure (EX) is an important prognostic factor for patients with colorectal cancer. However, the clinical significance of EX in the lateral pelvic lymph node area (LP-EX) remains unclear. This study aimed to determine the prognostic implications of LP-EX for patients with low rectal cancer. Methods: This retrospective study involved 172 consecutive patients with stage 2 or 3 low rectal cancer who underwent curative surgery including lateral pelvic lymph node (LPLN) dissection. The patients were classified into the following three groups according to the metastatic status of the LPLN area: patients without metastasis (no-LP-M group), patients with lymph node metastasis (LP-LNM group), and patients with EX (LP-EX group). Potential prognostic factors of overall survival (OS) and relapse-free survival (RFS) were identified in uni- and multivariate analyses. Results: Classification assigned 131 patients (76 %) to the no-LP-M group, 27 patients (16 %) to the LP-LNM group, and 14 patients (8 %) to the LP-EX group. The 5-year OS rate was 80.3 % in the no-LP-M group, 61.1 % in the LP-LNM group, and 34.9 % in the LP-EX group (P < 0.001). The corresponding 5-year RFS rates were 62.2, 33.8, and 14.3 %, respectively (P < 0.001). A multivariate Cox proportional hazards regression analysis showed that the presence of LP-EX was an independent prognostic factor for OS (P = 0.006) and RFS (P = 0.001). Conclusions: The LP-EX classification is a useful pathologic parameter that can be used to stratify patients with metastasis in the LPLN area.

Original languageEnglish
Pages (from-to)552-558
Number of pages7
JournalAnnals of Surgical Oncology
Volume23
DOIs
Publication statusPublished - 01-08-2016
Externally publishedYes

All Science Journal Classification (ASJC) codes

  • Surgery
  • Oncology

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