Does lymph node yield predict survival in locally advanced rectal cancers?

This study investigated the impact of lymph node yield (LNY) on the outcomes of patients with locally advanced rectal cancer. Researchers suggested that a LNY of 12 or more predict improved survival in these patients.

Colorectal cancer is the third most common cancer worldwide. Some patients present with locally advanced disease (spread to the lymph nodes) at diagnosis. The standard treatment for these patients is chemotherapy and radiation therapy followed by surgery. To decide on the best treatment tumor staging is necessary.

During surgery, it is recommended that at least 12 lymph nodes are collected for tumor staging. However, prior studies suggested that LNY of less than 12 indicated better tumor shrinkage and survival. It is not clear if an LNY of 12 is necessary for patients who underwent the standard treatment. Also, the impact of LNY on the survival of these patients is still under investigation.

This study included information about 495 patients who underwent standard treatment (chemoradiotherapy followed by surgery). 287 (57.9%) patients had an LNY of less than 12.

An LNY of 12 was associated with better overall survival, disease-free survival (time from treatment to progression) and metastasis-free survival (time from treatment to cancer spread) compared with an LNY lower than 12.

No significant difference was seen between patients with different LNYs depending on the response they had to chemoradiotherapy.

This study concluded that an LNY of at least 12 is associated with improved survival in patients with locally advanced rectal cancer who underwent standard treatment.