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Session: ePoster Monitor 6-Rectal Cancer 2

eP368 - Risk Factors for Lymph Node Metastasis in Early Rectal Cancer According to Neoadjuvant Chemoradiotherapy Status

Sunday, June 2, 2024
12:03 PM – 12:08 PM ET, USA
Location: Baltimore Convention Center, Room 318-320

    ePoster Presenter(s)

  • Young Hae Choi, MD

    Fellow
    Samsung Medical Center, Sungkyunkwan University School of Medicine
    Sungkyunkwan University School of Medicine
    Seoul, Seoul-t'ukpyolsi, Republic of Korea

    All of the relevant financial relationships listed below have been mitigated.
    This individual has no financial relationships with ineligible companies.

    • Senior Author(s)

  • JH

    Jung Wook Huh, M.D.

    Professor
    Samsung Medical Center, Sungkyunkwan University School of Medicine,
    Seoul, Seoul-t'ukpyolsi, Republic of Korea

    Disclosure information not submitted.

Purpose/Background: The aim of this study was to identify the risk factors of LN metastasis and to investigate the prognostic significance of LN metastasis for long-term outcomes in early rectal cancer after nCRT.Methods/Interventions: From January 2009 to December 2018, 1,193 patients with T1 or T2 rectal cancer who underwent radical surgery were analyzed retrospectively. Patients were divided into two groups according to nCRT status. Prognostic factors for LN metastasis and survival rate were evaluated for each group.Results/Outcomes: There were 763 patients (64%) in the non-nCRT group and 430 patients (36%) in the nCRT group. The incidence of lymph node metastasis was 21.2% (n=162) in the non-nCRT group and 17.7% (n=76) in the nCRT group.In the non-nCRT group, multivariate analysis showed that tumor invasion depth (P < 0.001), lymphatic invasion (P < 0.001), and tumor budding (P=0.006) were significant independent predictors of LN metastasis. The 5-year disease-free survival rate (DFS) was 93.7% in the LN-negative group and 87.6% in the LN-positive group (P=0.042), but there was no difference in local recurrence-free survival rate (LRFS) and overall survival rate (OS). Lymphatic invasion was the only variable affecting DFS in multivariate analysis (P < 0.001).In the nCRT group, multivariate analysis revealed that lymphatic invasion (P=0.001) and vascular invasion (P < 0.001) were significant independent risk factors of LN metastasis. There was a significant difference in DFS of 85.1% vs. 56.9% (P < 0.001) and LRFS of 95.6% vs. 76.1% (P=0.027) in the LN-negative and LN-positive groups, respectively, but no difference in OS. The risk factors associated with DFS were LN metastasis (P < 0.001) and perineural invasion (P=0.029), and the factor associated with LRFS was LN metastasis (P=0.023) accroding to multivariate analysis.Conclusion/

Discussion: In the non-nCRT group, tumor invasion depth, lymphatic invasion, and tumor budding were significant independent risk factors of LN metastasis. In the nCRT group, lymphatic invasion and vascular invasion were significant independent risk factors of LN metastasis."Table 1. Clinicopathological characteristics of study population

Table 2-4. Univariate and multivariate analysis of the factors associated with Lymph node positivity, Disease-free survival, Overall survival

Figure 1-3. Local recurrence-free survival, Disease-free survival, Overall survival curves according to neoadjuvant chemoradiotherapy status

Figure 4. Risk stratification by grouping the factors influencing lymph node metastasis
"