OPEN IN READ APP
JOURNAL ARTICLE

Indications for Lateral Pelvic Lymph Node Dissection Based on Magnetic Resonance Imaging Before and After Preoperative Chemoradiotherapy in Patients with Advanced Low-Rectal Cancer

Takashi Akiyoshi, Kiyoshi Matsueda, Makiko Hiratsuka, Toshiyuki Unno, Jun Nagata, Toshiya Nagasaki, Tsuyoshi Konishi, Yoshiya Fujimoto, Satoshi Nagayama, Yosuke Fukunaga, Masashi Ueno
Annals of Surgical Oncology 2015, 22 Suppl 3: S614-20
25896145

BACKGROUND: We assessed the magnetic resonance imaging (MRI) findings of lateral pelvic lymph node (LPLN) metastasis in patients with advanced low-rectal cancer treated with preoperative chemoradiotherapy (CRT) and LPLN dissection (LPLD) for clinically suspected LPLN metastasis. Our aim was to identify the optimal indications for LPLD.

METHODS: The study population consisted of 77 patients with advanced low-rectal cancer who underwent LPLD for clinically suspicious LPLN metastasis after preoperative CRT. MRI findings before/after CRT, clinical factors, and LPLN metastasis were evaluated.

RESULTS: LPLN metastasis was confirmed in 31 patients (40.3 %). Metastasis was significantly higher in patients with LPLNs with a short-axis diameter ≥8 mm than in patients with LPLNs with a short-axis diameter <8 mm before CRT (75 vs. 20 %, P < 0.0001). LPLN metastasis was also significantly higher in patients with LPLNs with a short-axis diameter >5 mm than in patients with LPLNs with a short-axis diameter ≤5 mm after CRT (75 vs. 20 %, P < 0.0001). Multivariate analysis showed the independent association of female sex [P = 0.0192; odds ratio (OR) 5.616; 95 % confidence interval (CI) 1.315-28.942], pre-CRT short-axis diameter of the LPLN ≥8 mm (P = 0.0047; OR 9.188; 95 % CI 1.948-54.366), and CRT without induction systemic chemotherapy (P = 0.0285; OR 9.235; 95 % CI 1.241-106.947) with LPLN metastasis.

CONCLUSIONS: MRI before CRT is useful to predict LPLN metastasis and to determine the indications for LPLD.

Comments

You need to log in or sign up for an account to be able to comment.

No comments yet, be the first to post one!

Related Papers

Available on the App Store

Available on the Play Store
Remove bar
Read by QxMD icon Read
25896145
×

Search Tips

Use Boolean operators: AND/OR

diabetic AND foot
diabetes OR diabetic

Exclude a word using the 'minus' sign

Virchow -triad

Use Parentheses

water AND (cup OR glass)

Add an asterisk (*) at end of a word to include word stems

Neuro* will search for Neurology, Neuroscientist, Neurological, and so on

Use quotes to search for an exact phrase

"primary prevention of cancer"
(heart or cardiac or cardio*) AND arrest -"American Heart Association"