Copyright: ©Author(s) 2026. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution-NonCommercial (CC BY-NC 4.0) license. No commercial re-use. See permissions. Published by Baishideng Publishing Group Inc.
World J Gastroenterol. Apr 21, 2026; 32(15): 116026
Published online Apr 21, 2026. doi: 10.3748/wjg.v32.i15.116026
Published online Apr 21, 2026. doi: 10.3748/wjg.v32.i15.116026
Lymph node regression grade as a prognostic marker in rectal cancer after neoadjuvant therapy and radical resection
Yun-Jie Shi, Qian-Qian Liu, Hong-Yan Ru, Ya-Jun Huang, Wen Xia, Xu Li, Department of Colorectal Surgery, Changhai Hospital, The First Affiliated Hospital of Naval Medical University, Shanghai 200433, China
Pan-Pan Duan, Ling Chen, Department of Anesthesiology, Changhai Hospital, The First Affiliated Hospital of Naval Medical University, Shanghai 200433, China
Co-first authors: Yun-Jie Shi and Pan-Pan Duan.
Co-corresponding authors: Ling Chen and Xu Li.
Author contributions: Shi YJ and Duan PP are co-first authors and contributed equally to this work, including design of the study, acquiring and analyzing data from experiments, and writing of the manuscript; Liu QQ, Ru HY, Huang YJ, and Xia W designed the experiments and conducted clinical data collection; Shi YJ, Duan PP, Chen L, and Li X performed postoperative follow-up and recorded the data, conducted the collation and statistical analysis, wrote the original manuscript and revised the paper; Chen L and Li X made equal contributions as co-corresponding authors; all authors read and approved the final manuscript.
Supported by Shanghai Municipal Health Commission, No. 20244Y0186.
Institutional review board statement: This study was approved by the Ethics Committee of Changhai Hospital, Second Military Medical University.
Informed consent statement: This study obtained informed consent forms signed by all patients.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Data sharing statement: All data generated or analyzed during this study are included in this published article.
Corresponding author: Xu Li, Department of Colorectal Surgery, Changhai Hospital, The First Affiliated Hospital of Naval Medical University, No. 168 Changhai Road, Yangpu District, Shanghai 200433, China. xuli_ch@163.com
Received: November 21, 2025
Revised: December 29, 2025
Accepted: February 4, 2026
Published online: April 21, 2026
Processing time: 144 Days and 22.3 Hours
Revised: December 29, 2025
Accepted: February 4, 2026
Published online: April 21, 2026
Processing time: 144 Days and 22.3 Hours
Core Tip
Core Tip: In locally advanced rectal cancer treated with neoadjuvant chemoradiotherapy, the prognostic value of the primary tumor regression grade is limited to patients without lymph node (LN) metastasis (ypN0). Importantly, we demonstrate that a novel LN regression grade, assessing residual cancer in treated LNs, serves as a powerful and independent prognostic marker for both survival and recurrence in patients with residual nodal disease (ypN+). Integrating LN regression grade into postoperative evaluation refines risk stratification beyond current tumor-node-metastasis staging.