Research Papers:

A scoring system basing pathological parameters to predict regional lymph node metastasis after preoperative chemoradiotherapy for locally advanced rectal cancer: implication for local excision

Xiao-Jie Wang, Pan Chi _, Hui-Ming Lin, Xing-Rong Lu, Ying Huang, Zong-Bin Xu, Sheng-Hui Huang, Yan-Wu Sun, Dao-Xiong Ye and Qian Yu

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Oncotarget. 2016; 7:78487-78498. https://doi.org/10.18632/oncotarget.10965

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Xiao-Jie Wang1, Pan Chi1, Hui-Ming Lin1, Xing-Rong Lu1, Ying Huang1, Zong-Bin Xu1, Sheng-Hui Huang1, Yan-Wu Sun1, Dao-Xiong Ye1, Qian Yu2

1Department of Colorectal Surgery, Union Hospital, Fujian Medical University, Fuzhou, Fujian 350001, People's Republic of China

2Department of Pathology, Union Hospital, Fujian Medical University, Fuzhou, Fujian 350001, People's Republic of China

Correspondence to:

Pan Chi, email: chipan363@163.com

Keywords: rectal cancer, preoperative chemoradiotherapy, regional nodal metastasis

Received: March 09, 2016     Accepted: July 09, 2016     Published: July 30, 2016


Local excision is an alternative to radical surgery that is indicated in patients with locally advanced rectal cancer (LARC) who have a good response to chemoradiotherapy (CRT). Regional lymph node status is a major uncertainty during local excision of LARC following CRT. We retrospectively reviewed clinicopathologic variables for 244 patients with LARC who were treated at our institute between December 2000 and December 2013 in order to identify independent predictors of regional lymph node metastasis. Multivariate analysis of the training sample demonstrated that histopathologic type, tumor size, and the presence of lymphovascular invasion were significant predictors of regional nodal metastasis. These variables were then incorporated into a scoring system in which the total scores were calculated based on the points assigned for each parameter. The area under the curve in the receiver operating characteristic analysis was 0.750, and the cutoff value for the total score to predict regional nodal metastasis was 7.5. The sensitivity of our system was 73.2% and the specificity was 69.4%. The sensitivity was 77.8% and the specificity was 51.2% when the scoring system was applied to the testing sample. Using this system, we could accurately predict regional nodal metastases in LARC patients following CRT, which may be useful for stratifying patients in clinical trials and selecting potential candidates for organ-sparing surgery following CRT for LARC

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