Selective lateral lymph node dissection after neoadjuvant chemoradiotherapy in rectal cancer

Table 1 Patient demographics, n = 89

Variables	Value
Gender, n (%)
Male	51 (57.3)
Female	38 (42.7)
Age in yr, mean ± SD	54.4 ± 10.1
BMI in kg/m2, mean ± SD	24.9 ± 4.6
ASA score, n (%)
ASA I	13 (14.6)
ASA II	56 (62.9)
ASA III	20 (22.5)
cT stage
cT3	54 (60.7)
cT4	35 (39.3)
cN stage
N1	50 (56.2)
N2	39 (43.8)
Neoadjuvant chemoradiotherapy
No	26 (29.2)
Short-course radiotherapy	3 (3.4)
Long-course radiotherapy + chemotherapy	60 (67.4)

ASA: American Society of Anesthesiologists; BMI: Body mass index; SD: Standard deviation.

Table 2 Surgery-related data

Variables	Value
Type of operation, n (%)
Low anterior resection	44 (49.4)
Intersphincteric resection	2 (2.2)
Hartmann's procedure	6 (6.7)
Abdominoperineal resection	37 (41.6)
Conversion to open, n (%)	2 (2.2)
Operation time in min, mean ± SD	290.7 ± 89.5
Estimated blood loss in mL, mean ± SD	79.2 ± 146.7
Temporary stoma, n (%)	9 (10.1)
Type of LLND, n (%)
Unilateral	76 (85.4)
Bilateral	13 (14.6)
Hospital stay after operation (d, mean ± SD)	8.5 ± 4.2
30 d post-operative mortality, n (%)	0
2-yr lateral local recurrence, n (%)	2 (2.2)
2-yr disease-free survival	80.90%
2-yr overall survival	91.00%

LLND: Lateral lymph node dissection; SD: Standard deviation.

Table 3 Postoperative complications, n = 89

Variables	Value, n (%)
Anastomotic leakage	4 (4.5)
Urinary retention	2 (2.2)
Wound infection	3 (3.4)
Bowel obstruction	4 (4.5)
Lymphatic leakage	1 (1.1)
Pelvic hemorrhage	1 (1.1)

Table 4 Pathological outcomes

Variables	Value
Tumor size in cm, mean ± SD	4.9 ± 2.3
Differentiation degree, n (%)
Poor	28 (31.5)
Moderate/well	61 (68.5)
Pathological LLN metastasis, n (%)
With NCRT	26 (41.3)
Without NCRT	9 (34.6)
Position of metastasis, n (%)
Internal iliac	12 (34.3)
Obturator	21 (60.0)
Bifurcation of abdominal aorta	2 (5.7)
R status, n (%)
R0	87 (97.8)
R1	2 (2.2)

LLN: Lateral lymph node; NRCT: Neoadjuvant chemoradiotherapy; SD: Standard deviation.

Table 5 Lateral lymph node metastatic rate for different cutoff values in short-axis in patients who received (chemo)radiotherapy, n = 63

Variables	Positive, n = 26	Negative, n = 37	P value
SA 5-7 mm, n (%)	3 (23.1)	10 (76.9)	0.216
SA 7-10 mm, n (%)	9 (39.1)	14 (60.9)
SA ≥ 10 mm, n (%)	14 (51.9)	13 (48.1)

SA: Short-axis.

Table 6 Risk factors for pathological lateral lymph node metastasis after neoadjuvant chemoradiotherapy, n = 63

Variables	Univariate analysis	Multivariate analysis
	P value	95%CI	P value
Sex	0.259	0.184-2.697	0.609
Male
Female
Age	0.987	0.242-3.269	0.889
≥ 60
< 60
cT stage	0.003	1.419-18.508	0.013
cT3
cT4
Histological type	0.183	1.038-15.520	0.044
Poor
Moderate/well
Short-axis	0.135	1.487-38.214	0.015
5-7 mm
≥ 7 mm
Mixed signal intensity of LLN	0.739	0.342-4.894	0.705
Yes
No
Border irregularity of LLN	0.315	0.119-1.675	0.232
Yes
No

LLN: Lateral lymph node.