Rectal Cancer Nodes Research Articles

The size of regional lymph nodes does not correlate with the presence or absence of metastasis in lymph nodes in rectal cancer.

We evaluated the relationship between the size of regional lymph nodes and the presence of metastasis in them in rectal cancer. Of 1,064 lymph nodes in 46 specimens, 133 (13%) were found to have metastases. A half of the positive nodes and most of the negative ones were less than 5 mm in diameter. Therefore, we must find lymph nodes smaller than 5 mm in diameter for assessment of lymph node metastasis. Although positive nodes were larger than negative ones, there was no significant difference. However, when comparing the size of lymph nodes in relation to their location, the epi- and pararectal lymph nodes larger than 10 mm in diameter were highly suggestive of metastases, but the size of the lymph node was not a reliable indicator of lymph node metastases in other situations.

Prognostic value of positive lymph nodes in rectal cancer.

Abdominal "curative" resections for rectal cancer in 109 patients with positive lymph nodes were prospectively studied. The best subdivision of patients for predicting outcome was into 1-3 and greater than 3 positive lymph node groups. Comparison with patients with greater than 3 positive lymph nodes demonstrated that patients with 1-3 positive nodes had less local (35.0 percent vs. 13.0 percent; P = 0.007) and less distant recurrence (45.0 percent vs. 26.0 percent; P = 0.04) and had much better crude five-year survival (58.2 percent vs. 17.0 percent; P less than 0.0001). For predicting postsurgical outcome in patients with positive lymph nodes, the results justify subdividing patients into the following two prognostic subgroups: 1) those with 1-3 involved lymph nodes and 2) those with metastatic tumor in four or more lymph nodes.