The impact of neoadjuvant chemoradiation in lymph node yield inprotectomy cancer specimens: P142


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Abstract

Aim:The number of lymph nodes harvested in rectal cancerprotectomy specimens is an important measure of surgical quality andprognosis. Neoadjuvant chemoradiation may have an impact on the usual standard number.Method:We evaluated the total number of lymph nodes and those containing tumour inproctectomy specimens of rectal cancer patients submitted to surgery or chemoradiotherapy plus surgery. Two hundred patients with mid and low rectal cancer were assessed. 143 pts (71.5%) were submitted to surgery (Group A) while 57 pts (28.5%) received neoadjuvant chemoradiation before operation (Group B). Theproctectomy specimen was analysed for the total number of lymph nodes found and those that were positive. Statistical analysis was carried out using SPSS 18.0 (t-Student, chisquare, Pearson correlation).Results:A statistically significant difference was seen between the two groups regarding the mean number of lymph nodes (Gr.A:14.66 vs Gr.B:10.21; P < 0.001). No statistically significant difference was found between the two groups concerning the mean number of positive lymph nodes (Gr.A:1.77 vs Gr.B:1.12; P = ns). Conclusion: neoadjuvant chemoradiation significantly decreases the number of lymph nodes in operative specimens. A new pathologic standard should be clarified in patients submitted to neoadjuvant treatment concerning the adequate number of lymph nodes that must be found.

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