The Effect of Preoperative Chemoradiotherapy on Lymph Node Harvest After Total Mesorectal Excision for Rectal Cancer

• Published in: Diseases of the colon & rectum Vol. 52; no. 8; pp. 1470 - 1474
• Main Authors: Taflampas, Panagiotis, Christodoulakis, Manousos, Gourtsoyianni, Sofia, Leventi, Katerina, Melissas, John, Tsiftsis, Dimitrios D
• Format: Journal Article
• Language: English
• Published: Hagerstown, MDc The ASCRS 01-08-2009; Lippincott Williams & Wilkins
• Subjects: Adenocarcinoma - secondary; Adenocarcinoma - therapy; Aged; Antineoplastic Agents - therapeutic use; Biological and medical sciences; Colectomy - methods; Female; Follow-Up Studies; Gastroenterology. Liver. Pancreas. Abdomen; Humans; Lymph Node Excision - methods; Lymph Nodes - pathology; Lymphatic Metastasis; Male; Medical sciences; Neoplasm Staging - methods; Preoperative Care - methods; Prognosis; Radiotherapy, Adjuvant; Rectal Neoplasms - pathology; Rectal Neoplasms - therapy; Retrospective Studies; Stomach, duodenum, intestine, rectum, anus; Stomach. Duodenum. Small intestine. Colon. Rectum. Anus; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Surgery of the digestive system; Tissue and Organ Harvesting - methods; Tumors; Lymph node retrieval; Proctectomy; Rectal disease; Lymph node; Rectal cancer; Preoperative chemoradiotherapy; Malignant tumor; Rectum cancer; Radiotherapy; Chemoradiotherapy; Lymph nodes; Preoperative radiotherapy; Treatment; Gastroenterology; Digestive diseases; Intestinal disease; Preoperative; Anorectal disease; Cancer
• DOI: 10.1007/DCR.0b013e3181a0e6ac
• EISSN: 1530-0358
• ISSN: 0012-3706

PURPOSE:This study was designed to evaluate whether preoperative chemoradiotherapy reduces the number of lymph nodes harvested after total mesorectal excision of rectal cancer.
METHODS:From January 1995 to December 2007, 168 consecutive patients with rectal cancer underwent total mesorectal excision in the Department of Surgical Oncology at the University of Crete. The patients were divided into three groups (Group A, no chemoradiotherapy; Group B, short course of chemoradiotherapy; Group C, long course of chemoradiotherapy). The primary end points were the number of lymph nodes examined and the percentage of patients with fewer than 12 lymph nodes removed.
RESULTS:The overall number of lymph nodes retrieved was not significantly reduced by the use of preoperative chemoradiotherapy. The percentage of patients with fewer than 12 lymph nodes examined, however, was significantly higher in Group C. The leakage rate and the duration of hospital stay were not affected. The rate of wound infections was higher in Group C.
CONCLUSION:Preoperative chemoradiotherapy did not significantly decrease the overall number of lymph nodes retrieved but did increase the percentage of patients with fewer than 12 lymph nodes examined.