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Predicting lymph node metastases in early rectal cancer
Division of Surgery, CLINTEC, Karolinska Institutet, Sweden.
Division of Surgery, CLINTEC, Karolinska Institutet, Sweden.
Division of Surgery, CLINTEC, Karolinska Institutet, Sweden.
2013 (English)In: European Journal of Cancer, ISSN 0959-8049, E-ISSN 1879-0852, Vol. 49, no 5, 1104-1108 p.Article in journal (Refereed) Published
Abstract [en]

AIM: In this population-based study, the aim was to investigate risk factors for lymph node metastases and to construct a risk stratification index with relevance for pre-operative planning in T1 and T2 rectal cancers.

METHODS: Data were retrieved from The Swedish Rectal Cancer Register, a mandatory, national, prospectively collected data base. All T1 and T2 rectal cancers treated with abdominal resection surgery without neo-adjuvant or adjuvant radio-chemotherapy from 2007 to 2010 were analysed. T-stage, sm-level, histologic differentiation, mucinous tumour type, blood vessel- and perineural infiltration, tumour location (in cm from the anal verge), age and gender were evaluated as potential predictors of lymph node metastases, using uni- and multivariate logistic regression.

RESULTS: T2-stage (odds ratio [OR]=2.0), poor differentiation (OR=6.5) and vascular infiltration (OR=4.3) were identified as significant risk-factors for lymph node metastases in the multivariate analysis. The risk stratification index shows the risk for lymph node metastases gradually increasing from 6% to 65% and 11% to 78% in T1 and T2 cancers respectively, when adding the risk factors one by one.

CONCLUSION: There is a considerable span in the risk for lymph node metastases between low risk T1 and high risk T2 rectal cancer. Using the risk stratification-model, with the concept of local excision as a macro-biopsy with standby for subsequent immediate radical resection surgery in high-risk cases, could benefit patients by providing the advantages of local excision yet ensuring adequate oncologic outcome.

Place, publisher, year, edition, pages
2013. Vol. 49, no 5, 1104-1108 p.
National Category
URN: urn:nbn:se:umu:diva-83430DOI: 10.1016/j.ejca.2012.10.005ISI: 000315945500015PubMedID: 23122785OAI: diva2:667124
Available from: 2013-11-25 Created: 2013-11-25 Last updated: 2016-09-07Bibliographically approved

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