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Research ArticleClinical Studies

Predictors of Lateral Pelvic Lymph Node Metastasis in Advanced Low Rectal Cancer Treated With Neoadjuvant Chemotherapy

TETSUO ISHIZAKI, KENJI KATSUMATA, MASANOBU ENOMOTO, JUNICHI MAZAKI, RYUTARO UDO, TOMOYA TAGO, KENTA KASAHARA, HIROSHI KUWABARA, YUICHI NAGAKAWA and AKIHIKO TSUCHIDA
Anticancer Research April 2022, 42 (4) 2113-2121; DOI: https://doi.org/10.21873/anticanres.15693
TETSUO ISHIZAKI
Department of Gastrointestinal and Pediatric Surgery, Tokyo Medical University, Tokyo, Japan
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  • For correspondence: wbc15000@yahoo.co.jp
KENJI KATSUMATA
Department of Gastrointestinal and Pediatric Surgery, Tokyo Medical University, Tokyo, Japan
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MASANOBU ENOMOTO
Department of Gastrointestinal and Pediatric Surgery, Tokyo Medical University, Tokyo, Japan
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JUNICHI MAZAKI
Department of Gastrointestinal and Pediatric Surgery, Tokyo Medical University, Tokyo, Japan
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RYUTARO UDO
Department of Gastrointestinal and Pediatric Surgery, Tokyo Medical University, Tokyo, Japan
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TOMOYA TAGO
Department of Gastrointestinal and Pediatric Surgery, Tokyo Medical University, Tokyo, Japan
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KENTA KASAHARA
Department of Gastrointestinal and Pediatric Surgery, Tokyo Medical University, Tokyo, Japan
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HIROSHI KUWABARA
Department of Gastrointestinal and Pediatric Surgery, Tokyo Medical University, Tokyo, Japan
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YUICHI NAGAKAWA
Department of Gastrointestinal and Pediatric Surgery, Tokyo Medical University, Tokyo, Japan
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AKIHIKO TSUCHIDA
Department of Gastrointestinal and Pediatric Surgery, Tokyo Medical University, Tokyo, Japan
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Abstract

Background/Aim: This retrospective study used magnetic resonance imaging to identify clinicopathological predictors of lateral pelvic lymph node metastasis in patients with advanced low rectal cancer treated with neoadjuvant chemotherapy; only few such studies have been reported. Patients and Methods: Sixty-one patients with advanced low rectal cancer who underwent total mesorectal excision and lateral pelvic lymph node dissection after neoadjuvant chemotherapy between April 2013 and December 2019 were included in this study. Univariate and multivariate analyses were used to analyze the relationship between lateral pelvic lymph node metastasis and clinicopathological factors, such as lateral pelvic lymph node size, measured before and after neoadjuvant chemotherapy using magnetic resonance imaging. Results: The short-axis diameter of lateral pelvic lymph nodes before neoadjuvant chemotherapy (p=0.003, odds ratio: 2.898, 95% confidence interval=1.534-9.143) was the only identified independent preoperative predictor. Based on the receiver operating characteristic curve analysis, the cut-off value of the short-axis diameter of lateral pelvic lymph nodes before neoadjuvant chemotherapy was 6.8 mm. The area under the curve was 0.761 (95% confidence interval=0.723-0.932). The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy were 77.8%, 72.1%, 53.8%, 88.6%, and 73.8%, respectively. Conclusion: The preoperative predictor of lateral pelvic lymph node metastasis in advanced low rectal cancer treated with neoadjuvant chemotherapy was the short-axis diameter of lateral pelvic lymph nodes before neoadjuvant chemotherapy. When lateral pelvic lymph nodes with short-axis diameters above 6.8 mm are present, lateral pelvic lymph node dissection may be necessary.

Key Words:
  • Predictors
  • lateral pelvic lymph node metastasis
  • advanced low rectal cancer
  • size criterion
  • magnetic resonance imaging
  • Received January 21, 2022.
  • Revision received February 11, 2022.
  • Accepted February 14, 2022.
  • Copyright © 2022 International Institute of Anticancer Research (Dr. George J. Delinasios), All rights reserved.
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Anticancer Research: 42 (4)
Anticancer Research
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April 2022
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Predictors of Lateral Pelvic Lymph Node Metastasis in Advanced Low Rectal Cancer Treated With Neoadjuvant Chemotherapy
TETSUO ISHIZAKI, KENJI KATSUMATA, MASANOBU ENOMOTO, JUNICHI MAZAKI, RYUTARO UDO, TOMOYA TAGO, KENTA KASAHARA, HIROSHI KUWABARA, YUICHI NAGAKAWA, AKIHIKO TSUCHIDA
Anticancer Research Apr 2022, 42 (4) 2113-2121; DOI: 10.21873/anticanres.15693

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Predictors of Lateral Pelvic Lymph Node Metastasis in Advanced Low Rectal Cancer Treated With Neoadjuvant Chemotherapy
TETSUO ISHIZAKI, KENJI KATSUMATA, MASANOBU ENOMOTO, JUNICHI MAZAKI, RYUTARO UDO, TOMOYA TAGO, KENTA KASAHARA, HIROSHI KUWABARA, YUICHI NAGAKAWA, AKIHIKO TSUCHIDA
Anticancer Research Apr 2022, 42 (4) 2113-2121; DOI: 10.21873/anticanres.15693
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Keywords

  • Predictors
  • lateral pelvic lymph node metastasis
  • advanced low rectal cancer
  • size criterion
  • magnetic resonance imaging
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