KEY TAKEAWAYS
- The study aimed to investigate the distribution characteristics and prognostic significance of LLNs in patients with rectal cancer.
- Researchers noticed that patients with rectal cancer having LLN have better prognoses, underscoring the value of locoregional treatment.
Information regarding the distribution characteristics and prognostic significance of lateral lymph nodes (LLNs) identified on primary computed tomography (CT) scans in patients with rectal cancer is currently insufficient.
Xuyang Yang and the team aimed to investigate these aspects to provide clarity on how LLNs relate to patient outcomes.
They performed an inclusive analysis of patients with pathologically confirmed rectal cancer who underwent pretreatment abdominal enhanced CT in the department between January 2013 and December 2016. LLNs were reclassified into 7 categories based on their locations.
The number and distribution of all measurable LLNs were documented, along with the characteristics of the largest LLN in each lateral compartment. Additionally, the long-term outcomes of patients with varying LLN characteristics and LLN risk scores were investigated.
About 572 patients were enrolled in this study, with approximately 80% having measurable LLNs, predominantly found in the obturator cranial compartment. Lateral local recurrence (LLR) occurred in 20 patients, representing 83.3% of the local recurrence (LR) cases.
Patients with the largest LLN short-axis diameter >10 mm exhibited poor prognoses, similar to those with simultaneous distant metastasis (SDM). Additionally, patients with LLN risk scoring ≥2 experienced worse prognoses compared to those with LLN risk scoring <2 but fared better than those with SDM.
The study concluded that LLR represents the primary locoregional recurrence pattern in rectal cancer. Most patients exhibit measurable LLNs on primary CT scans. Notably, patients with enlarged LLNs <10 mm or LLN risk scoring <2 demonstrate significantly better prognoses compared to those with simultaneous distant metastasis (SDM), highlighting the potential value of locoregional treatment for these LLNs.
This study was funded by the Department of Science and Technology of Sichuan Province (2023YFS0277; 2021YFS0025), West China Hospital, Sichuan University (20HXJS003); 1·3·5 project for disciplines of excellence-Clinical Research Incubation Project, and West China Hospital, Sichuan University (22HXFH001; 2019HXFH031); Post-Doctor Research Project, West China Hospital, Post-Doctor Research Project, China Postdoctoral Science Foundation (2022 M712264), the Ethicon Excellent in Surgery Grant (EESG) (No HZB-20190528-4).
Source: https://pubmed.ncbi.nlm.nih.gov/39312477/
Yang X, Zhang Y, Zhuang Z, et al. (2024). “Cross-sectional investigation of the distribution characteristics and prognostic significance of lateral lymph nodes in patients with rectal cancer.” Cancer Med. 2024;13(18):e70170. doi:10.1002/cam4.70170
