PMID- 31427089
OWN - NLM
STAT- MEDLINE
DCOM- 20201215
LR  - 20201215
IS  - 1878-3562 (Electronic)
IS  - 1590-8658 (Linking)
VI  - 52
IP  - 2
DP  - 2020 Feb
TI  - YpN0 rectal cancer patients with sterilized lymph nodes after neoadjuvant 
      chemoradiotherapy are of greater risk of recurrence.
PG  - 214-220
LID - S1590-8658(19)30715-7 [pii]
LID - 10.1016/j.dld.2019.07.013 [doi]
AB  - BACKGROUND: Indication for adjuvant chemotherapy in ypN0 rectal cancer patients 
      after chemoradiotherapy (CRT) is debated. The clinical significance of the 
      presence of sterilized lymph nodes (LNS) in ypN0 patients remains to be 
      determined. AIMS: To assess the prognostic value of LNS in ypN0 rectal cancers 
      after neoadjuvant CRT. METHODS: From 2006-2016, 235 patients underwent TME 
      surgery for non-metastatic mid-low rectal cancer after CRT. A lymph node was 
      considered sterilized if there were signs of treatment response (fibrosis, 
      necrosis or mucus) without residual tumor cells. RESULTS: 180 patients (77%) were 
      classified ypN0 and 55 (23%) ypN+. LNS was present in 20 patients (9%). In ypN0 
      patients, 5-year OS was similar between patients with and without LNS. In 
      contrast, 5-year DFS was significantly lower in ypN0/LNS + patients (58% vs. 78%, 
      p = 0.043) and was similar to those staged ypN+. In multivariate analysis, two 
      factors were independent predictors of DFS: mesorectal grading (OR = 3.14; 95%CI: 
      1.10-8.34; p = 0.033) and the presence of LNS (OR = 3.93, 95% CI: 1.06-11.81, 
      p = 0.042) CONCLUSION: The presence of LNS in ypN0 rectal cancer after 
      neoadjuvant CRT is associated with an increased risk of recurrence and may be 
      taken into account for the discussion of adjuvant chemotherapy.
CI  - Copyright (c) 2019 Editrice Gastroenterologica Italiana S.r.l. Published by 
      Elsevier Ltd. All rights reserved.
FAU - Manceau, Gilles
AU  - Manceau G
AD  - Department of Digestive and Hepato-Pancreato-Biliary Surgery, Sorbonne 
      Universite, Assistance Publique-Hopitaux de Paris, Pitie-Salpetriere University 
      Hospital, Paris, France.
FAU - Margot, Nicolas
AU  - Margot N
AD  - Department of Digestive and Hepato-Pancreato-Biliary Surgery, Sorbonne 
      Universite, Assistance Publique-Hopitaux de Paris, Pitie-Salpetriere University 
      Hospital, Paris, France.
FAU - Augustin, Jeremy
AU  - Augustin J
AD  - Department of Pathology, Sorbonne Universite, Assistance Publique-Hopitaux de 
      Paris, Pitie-Salpetriere University Hospital, Paris, France.
FAU - Bardier, Armelle
AU  - Bardier A
AD  - Department of Pathology, Sorbonne Universite, Assistance Publique-Hopitaux de 
      Paris, Pitie-Salpetriere University Hospital, Paris, France.
FAU - Simon, Jean-Marc
AU  - Simon JM
AD  - Department of Radiotherapy, Sorbonne Universite, Assistance Publique-Hopitaux de 
      Paris, Pitie-Salpetriere University Hospital, Paris, France.
FAU - Bachet, Jean-Baptiste
AU  - Bachet JB
AD  - Department of Hepato-Gastroenterology and Digestive Oncology, Sorbonne 
      Universite, Assistance Publique-Hopitaux de Paris, Pitie-Salpetriere University 
      Hospital, Paris, France.
FAU - Spano, Jean-Philippe
AU  - Spano JP
AD  - Department of Medical Oncology, Sorbonne Universite, Assistance Publique-Hopitaux 
      de Paris, Pitie-Salpetriere University Hospital, Paris, France.
FAU - Maingon, Philippe
AU  - Maingon P
AD  - Department of Radiotherapy, Sorbonne Universite, Assistance Publique-Hopitaux de 
      Paris, Pitie-Salpetriere University Hospital, Paris, France.
FAU - Vaillant, Jean-Christophe
AU  - Vaillant JC
AD  - Department of Digestive and Hepato-Pancreato-Biliary Surgery, Sorbonne 
      Universite, Assistance Publique-Hopitaux de Paris, Pitie-Salpetriere University 
      Hospital, Paris, France.
FAU - Karoui, Mehdi
AU  - Karoui M
AD  - Department of Digestive and Hepato-Pancreato-Biliary Surgery, Sorbonne 
      Universite, Assistance Publique-Hopitaux de Paris, Pitie-Salpetriere University 
      Hospital, Paris, France. Electronic address: mehdi.karoui@aphp.fr.
LA  - eng
PT  - Journal Article
DEP - 20190816
PL  - Netherlands
TA  - Dig Liver Dis
JT  - Digestive and liver disease : official journal of the Italian Society of 
      Gastroenterology and the Italian Association for the Study of the Liver
JID - 100958385
RN  - U3P01618RT (Fluorouracil)
SB  - IM
MH  - Adult
MH  - Aged
MH  - Aged, 80 and over
MH  - Antineoplastic Combined Chemotherapy Protocols/therapeutic use
MH  - Chemoradiotherapy, Adjuvant
MH  - Disease-Free Survival
MH  - Female
MH  - Fluorouracil/administration & dosage
MH  - Humans
MH  - Lymph Nodes/*pathology
MH  - Lymphatic Metastasis/pathology
MH  - Male
MH  - Middle Aged
MH  - Neoplasm Grading
MH  - Neoplasm Recurrence, Local/*pathology
MH  - Neoplasm Staging
MH  - Neoplasm, Residual
MH  - Preoperative Care
MH  - Rectal Neoplasms/*pathology/*therapy
MH  - Retrospective Studies
MH  - Survival Rate
MH  - Young Adult
OTO - NOTNLM
OT  - neoadjuvant chemoradiotherapy
OT  - rectal cancer
OT  - sterilized lymph node
OT  - survival
EDAT- 2019/08/21 06:00
MHDA- 2020/12/16 06:00
CRDT- 2019/08/21 06:00
PHST- 2019/03/27 00:00 [received]
PHST- 2019/07/13 00:00 [revised]
PHST- 2019/07/17 00:00 [accepted]
PHST- 2019/08/21 06:00 [pubmed]
PHST- 2020/12/16 06:00 [medline]
PHST- 2019/08/21 06:00 [entrez]
AID - S1590-8658(19)30715-7 [pii]
AID - 10.1016/j.dld.2019.07.013 [doi]
PST - ppublish
SO  - Dig Liver Dis. 2020 Feb;52(2):214-220. doi: 10.1016/j.dld.2019.07.013. Epub 2019 
      Aug 16.