Niccolò Petrucciani1, Maria Clotilde Carra2, Aleix Martínez-Pérez3, Giulio Cesare Vitali4, Filippo Landi5, Pietro Genova1, Riccardo Memeo6, Francesco Brunetti1, Eloy Espin5, Frederic Ris4, Nicola De'angelis7. 1. Unit of Digestive, Hepato-Pancreato-Biliary Surgery and Liver Transplantation, Henri Mondor Hospital, AP-HP, University of Paris Est, UPEC, Créteil, France. 2. Rothschild Hospital, AP-HP, Paris VII University, Paris, France. 3. Unit of Colorectal Surgery, Department of General and Digestive Surgery, Doctor Peset University Hospital, Valencia, Spain. 4. Service of Abdominal Surgery, Geneva University Hospitals and Medical School, Geneva, Switzerland. 5. Unit of Colorectal Surgery, Department of General and Digestive Surgery, University Hospital Vall d'Hebron, Barcelona, Spain. 6. Department of General Surgery I, F. Miulli Regional General Hospital, Acquaviva delle Fonti, Bari, Italy. 7. Unit of Digestive, Hepato-Pancreato-Biliary Surgery and Liver Transplantation, Henri Mondor Hospital, AP-HP, University of Paris Est, UPEC, Créteil, France nic.deangelis@yahoo.it.
Abstract
BACKGROUND/AIM: The aim of this study was to compare the ability of different lymph nodal staging systems to predict cancer recurrence in a multicenter European series of patients who underwent proctectomy after neoadjuvant chemoradiotherapy for locally advanced rectal cancer. PATIENTS AND METHODS: Data on 170 consecutive patients undergoing proctectomy after neoadjuvant therapy for cT3-4 or cN+ rectal adenocarcinoma were retrieved from the European MRI and Rectal Cancer Surgery database. The prognostic role of the number of retrieved and examined nodes, nodal ratio, and log odds of positive lymph nodes (LODDS) was analyzed and compared by receiver operating characteristic curves, Pearson test, and univariate and multivariate analysis. RESULTS: At multivariate analysis, ypN, nodal ratio, and LODDS were all significantly associated with disease-free survival, but LODDS showed the strongest association (hazard ratio(HR)=2.39; 95% confidence interval(CI)=1.05-5.48; p=0.039). CONCLUSION: LODDS appears to be a useful prognostic indicator in the prediction of disease-free survival of patients undergoing neoadjuvant chemoradiotherapy and proctectomy for locally advanced rectal cancer. Copyright
BACKGROUND/AIM: The aim of this study was to compare the ability of different lymph nodal staging systems to predict cancer recurrence in a multicenter European series of patients who underwent proctectomy after neoadjuvant chemoradiotherapy for locally advanced rectal cancer. PATIENTS AND METHODS: Data on 170 consecutive patients undergoing proctectomy after neoadjuvant therapy for cT3-4 or cN+ rectal adenocarcinoma were retrieved from the European MRI and Rectal Cancer Surgery database. The prognostic role of the number of retrieved and examined nodes, nodal ratio, and log odds of positive lymph nodes (LODDS) was analyzed and compared by receiver operating characteristic curves, Pearson test, and univariate and multivariate analysis. RESULTS: At multivariate analysis, ypN, nodal ratio, and LODDS were all significantly associated with disease-free survival, but LODDS showed the strongest association (hazard ratio(HR)=2.39; 95% confidence interval(CI)=1.05-5.48; p=0.039). CONCLUSION:LODDS appears to be a useful prognostic indicator in the prediction of disease-free survival of patients undergoing neoadjuvant chemoradiotherapy and proctectomy for locally advanced rectal cancer. Copyright