Value of Size and Malignant Features of Lateral Lymph Nodes in Risk Stratification at Lateral Local Recurrence of Rectal Cancer: A National Cohort Study: A National Cohort Study
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| Title: | Value of Size and Malignant Features of Lateral Lymph Nodes in Risk Stratification at Lateral Local Recurrence of Rectal Cancer: A National Cohort Study: A National Cohort Study |
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| Authors: | Geffen, E.G.M. van, Sluckin, T.C., Hazen, S.J.A., Horsthuis, K., Beets-Tan, R.G.H., Dieren, S. van, Marijnen, C.A.M., Wilt, J.H.W. de, Tanis, P.J., Kusters, M. |
| Source: | van Geffen, E G M, Sluckin, T C, Hazen, S-M J A, Horsthuis, K, Beets-Tan, R G H, van Dieren, S, Marijnen, C A M, Tanis, P J & Kusters, M 2024, 'Value of Size and Malignant Features of Lateral Lymph Nodes in Risk Stratification at Lateral Local Recurrence of Rectal Cancer : A National Cohort Study', Journal of the national comprehensive cancer network, vol. 22, no. 1, pp. 17-25. https://doi.org/10.6004/jnccn.2023.7081 Journal of the National Comprehensive Cancer Network, 22, 1, pp. 17-25 |
| Publisher Information: | Harborside Press, LLC, 2024. |
| Publication Year: | 2024 |
| Subject Terms: | malignant features, Risk Assessment, Cohort Studies, SDG 3 - Good Health and Well-being, Humans, rectal cancer, Rectal Neoplasms/diagnostic imaging epidemiology therapy, 10. No inequality, Retrospective Studies, Neoplasm Staging, risk-stratification, Local/epidemiology, Rectal Neoplasms, Lymph Node Excision/methods, Local/epidemiology pathology, 3. Good health, lateral lymph nodes, Neoplasm Recurrence, Cross-Sectional Studies, Lymph Nodes/pathology, Rectal Neoplasms/diagnostic imaging, lateral local recurrence, Lymph Node Excision, Lymph Nodes, Neoplasm Recurrence, Local, Surgery - Radboud University Medical Center |
| Description: | Background: Patients with rectal cancer who have enlarged lateral lymph nodes (LLNs) have an increased risk of lateral local recurrence (LLR). However, little is known about prognostic implications of malignant features (internal heterogeneity, irregular margins, loss of fatty hilum, and round shape) on MRI and number of enlarged LLNs, in addition to LLN size. Methods: Of the 3,057 patients with rectal cancer included in this national, retrospective, cross-sectional cohort study, 284 with a cT3–4 tumor located ≤8 cm from the anorectal junction who received neoadjuvant treatment and who had visible LLNs on MRI were selected. Imaging was reassessed by trained radiologists. LLNs were categorized based on size. Influence of malignant features and the number of LLNs on LLR was investigated. Results: Of 284 patients with at least 1 visible LLN, 122 (43%) had an enlarged node (≥7.0 mm) and 157 (55%) had malignant features. Of the 122 patients with enlarged nodes, 25 had multiple (≥2). In patients with a single enlarged node (n=97), a single malignant feature was associated with a 4-year LLR rate of 0% and multiple malignant features was associated with a rate of 17% (P=.060). In the group with multiple malignant features, their disappearance on restaging was associated with an LLR rate of 13% compared with an LLR rate of 20% for persistent malignant features (P=.532). The presence of intermediate-size LLNs (5.0–6.9 mm) with at least 1 malignant feature was associated with a 4-year LLR rate of 8%; the 4-year LLR rate was 13% when the malignant features persisted on restaging MRI (P=.409). Patients with multiple enlarged LLNs had a 4-year LLR rate of 28% compared with 11% for those with a single enlarged LLN (P=.059). Conclusions: The presence of multiple enlarged LLNs (≥7.0 mm), as well as multiple malignant features in an enlarged node contribute to the risk of developing an LLR. These radiologic features can be used for clinical decision-making regarding the potential benefit of LLN dissection. |
| Document Type: | Article |
| ISSN: | 1540-1413 1540-1405 |
| DOI: | 10.6004/jnccn.2023.7081 |
| Access URL: | https://pubmed.ncbi.nlm.nih.gov/38394768 https://hdl.handle.net/https://repository.ubn.ru.nl/handle/2066/314986 https://doi.org/10.6004/jnccn.2023.7081 https://research.rug.nl/en/publications/318549c4-76a7-4245-bff1-2542707cf3da https://hdl.handle.net/11370/318549c4-76a7-4245-bff1-2542707cf3da https://doi.org/10.6004/jnccn.2023.7081 https://cris.maastrichtuniversity.nl/en/publications/ed4dc2c1-4b85-4be0-b69c-af88228132f7 https://doi.org/10.6004/jnccn.2023.7081 https://research.vumc.nl/en/publications/d4276c69-cea6-4cf6-b0bb-73ce322e921e https://pure.amsterdamumc.nl/en/publications/2dd182e1-3420-4c9a-82cb-6dfb6e5b0a91 https://doi.org/10.6004/jnccn.2023.7081 https://hdl.handle.net/2066/314986 https://repository.ubn.ru.nl//bitstream/handle/2066/314986/314986.pdf https://portal.findresearcher.sdu.dk/da/publications/0cdaebd6-7844-4069-94cf-75d4b390e004 https://doi.org/10.6004/jnccn.2023.7081 |
| Rights: | taverne CC BY |
| Accession Number: | edsair.doi.dedup.....2768f8b0f0d72eee547389ea2d007daa |
| Database: | OpenAIRE |
Nájsť tento článok vo Web of Science | Abstract: | Background: Patients with rectal cancer who have enlarged lateral lymph nodes (LLNs) have an increased risk of lateral local recurrence (LLR). However, little is known about prognostic implications of malignant features (internal heterogeneity, irregular margins, loss of fatty hilum, and round shape) on MRI and number of enlarged LLNs, in addition to LLN size. Methods: Of the 3,057 patients with rectal cancer included in this national, retrospective, cross-sectional cohort study, 284 with a cT3–4 tumor located ≤8 cm from the anorectal junction who received neoadjuvant treatment and who had visible LLNs on MRI were selected. Imaging was reassessed by trained radiologists. LLNs were categorized based on size. Influence of malignant features and the number of LLNs on LLR was investigated. Results: Of 284 patients with at least 1 visible LLN, 122 (43%) had an enlarged node (≥7.0 mm) and 157 (55%) had malignant features. Of the 122 patients with enlarged nodes, 25 had multiple (≥2). In patients with a single enlarged node (n=97), a single malignant feature was associated with a 4-year LLR rate of 0% and multiple malignant features was associated with a rate of 17% (P=.060). In the group with multiple malignant features, their disappearance on restaging was associated with an LLR rate of 13% compared with an LLR rate of 20% for persistent malignant features (P=.532). The presence of intermediate-size LLNs (5.0–6.9 mm) with at least 1 malignant feature was associated with a 4-year LLR rate of 8%; the 4-year LLR rate was 13% when the malignant features persisted on restaging MRI (P=.409). Patients with multiple enlarged LLNs had a 4-year LLR rate of 28% compared with 11% for those with a single enlarged LLN (P=.059). Conclusions: The presence of multiple enlarged LLNs (≥7.0 mm), as well as multiple malignant features in an enlarged node contribute to the risk of developing an LLR. These radiologic features can be used for clinical decision-making regarding the potential benefit of LLN dissection. |
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| ISSN: | 15401413 15401405 |
| DOI: | 10.6004/jnccn.2023.7081 |