Evaluation of lymphadenectomy in patients receiving neoadjuvant radiotherapy for rectal adenocarcinoma

Abstract

Objective The objective of this study was to evaluate the effect of neoadjuvant radiation on total number and number of positive lymph nodes (LNs) in patients with rectal adenocarcinoma. Background Colorectal cancer is the third most common cancer worldwide. Treatments for colorectal cancer include combinations of surgery, radiation therapy, chemotherapy, and targeted therapy. Neoadjuvant therapy aims to reduce the size or extent of the cancer before radical-treatment intervention, thus making the procedures easier and more likely to succeed. Patients and methods A total of 20 patients with stage 2 and stage 3 cancer were chosen and divided into two groups. The first group included 10 patients who received neoadjuvant therapy before radical surgery for rectal cancer. The second group included 10 patients who underwent radical surgery for rectal cancer without neoadjuvant therapy. For compression number of LNs in both groups before and after course of neoadjuvant and after surgery. Results Neoadjuvant therapy significantly decreased both the number and size of affected LNs in rectal cancer. Conclusion Neoadjuvant therapy was associated with decreased number of affected LNs up to complete clearance. There is a need for more larger randomized trials using preoperative chemoradiotherapy with larger number of patients for better evaluation of response and toxicity in comparison with postoperative chemoradiotherapy.