ArticleCancer medicine2020
The prognostic significance of the treatment response of regional lymph nodes and the refinement of the current TNM staging system in locally advanced rectal cancer after neoadjuvant chemoradiotherapy.
Article in Cancer medicine, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.
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7 citing papers in PubMed.
- Development and validation of an interpretable MRI-based multimodal fusion model for predicting lymph node metastasis after neoadjuvant chemoradiotherapy in locally advanced rectal cancer: a multicenter study.Abdominal radiology (New York) · 2026Article
- Lymph node regression score and highest nodal metastatic station: refining prognostic stratification in chemoradiotherapy-treated rectal mucinous adenocarcinoma.Virchows Archiv : an international journal of pathology · 2026Article
- Multimodal Management of Retroperitoneal Lymph Node Metastases in Colorectal Cancer: A Single-Center Retrospective Analysis.Annals of surgical oncology · 2026Article
- Discrepancies in the Reactivity of Mesorectal versus Lateral Lymph Nodes Post-Neoadjuvant Chemoradiotherapy for Rectal Cancer: Insights from Radiological and Pathological Perspectives.Annals of surgical oncology · 2025Article
- Comparation between novel online models and the AJCC 8th TNM staging system in predicting cancer-specific and overall survival of small cell lung cancer.Frontiers in endocrinology · 2023Article
- Lymph node regression grading of locally advanced rectal cancer treated with neoadjuvant chemoradiotherapy.World journal of gastrointestinal oncology · 2022Review
- Risk factors for long-term survival in patients with ypN+ M0 rectal cancer after radical anterior resection.BMC gastroenterology · 2022Article
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8 authors.
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Abstract
The current TNM staging system uses the same category definitions for both rectal cancer patients with and without neoadjuvant chemoradiotherapy (NCRT). However, ypTNM stage, especially ypN stage does not predict patient survival after NCRT well. Whether tumor regression in lymph nodes (LRG) may improve the prediction has not been well studied. In total, 358 patients with rectal cancer who received NCRT followed by radical resection were recruited from 2004 to 2015, and the median follow-up time was 57.5 months. The main outcome measure was disease-free survival (DFS). In univariate analysis, factors associated with DFS were ypT stage, ypN stage, number of negative lymph nodes (NLN), lymph node ratio (LNR), tumor regression grade (TRG), M-TTRG (modified ypT stage by combining ypT stage and TRG), maximum LRG (LRGmax), sum score of LRG (LRGsum), LRG ratio (average value of LRGsum), and M-NLRG (modified ypN stage by combining LRGmax and LNR). In the multivariate Cox regression analysis, M-TTRG and M-NLRG (p < 0.001 and p = 0.030, respectively) were significantly associated with DFS. The estimated 5-year DFS rates were 86.6%, 60.3%, and 36.4% for patients with M-NLRG-0, M-NLRG-1, and M-NLRG-2, respectively (p < 0.001). A significant difference in survival was observed among patients with NCRT after incorporating TRG and LRG simultaneously into the current ypTNM staging system (p < 0.001). LRG was an important prognostic factor in rectal cancer patients treated with NCRT and could refine the ypTNM staging system. The modified ypTNM staging system in combination with LRGmax, LNR, and TRG could improve the DFS prediction in each subset of patients.
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