Letter to the Editor: Lymph node regression grade in rectal cancer: Comments on prognostic utility and unresolved questions

doi:10.4251/wjgo.123926

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World Journal of Gastrointestinal Oncology

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1948-5204

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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA

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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 Gastrointest Oncol. Nov 15, 2026; 18(11): 123926
Published online Nov 15, 2026. doi: 10.4251/wjgo.123926

Letter to the Editor: Lymph node regression grade in rectal cancer: Comments on prognostic utility and unresolved questions

Olga V Smirnova, Aleksander A Sinyakov, Edward V Kasparov

Olga V Smirnova, Aleksander A Sinyakov, Laboratory of Clinical Pathophysiology, Federal Research Center “Krasnoyarsk Scientific Center of the Siberian Branch of the Russian Academy of Sciences”, Separate Subdivision Research Institute for Medical Problems of the North, Krasnoyarsk 660022, Russia

Edward V Kasparov, Department of Administration, Federal Research Center “Krasnoyarsk Scientific Center of the Siberian Branch of the Russian Academy of Sciences”, Separate Subdivision Research Institute for Medical Problems of the North, Krasnoyarsk 660022, Russia

Author contributions: Smirnova OV wrote the original draft; Sinyakov AA contributed to conceptualization, writing, reviewing and editing; Kasparov EV participated in manuscript drafting. All the authors have read and approved the final version of the manuscript.

AI contribution statement: We gratefully acknowledge DeepSeek Chat for providing assistance in refining the grammar and style of this manuscript.

Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.

Corresponding author: Olga V Smirnova, Professor, Laboratory of Clinical Pathophysiology, Federal Research Center “Krasnoyarsk Scientific Center of the Siberian Branch of the Russian Academy of Sciences”, Separate Subdivision Research Institute for Medical Problems of the North, Partizana Zheleznyaka Street 3G, Krasnoyarsk 660022, Russia. ovsmirnova71@mail.ru

Received: June 4, 2026
Revised: July 27, 2026
Accepted: August 5, 2026
Published online: November 15, 2026
Processing time: 147 Days and 20.6 Hours

Core Tip

Core Tip: The lymph node regression grade system by Shi et al advances post-neoadjuvant assessment of rectal cancer and enables prognostic stratification in ypN+ patients. However, its clinical use is limited by the difficulty of distinguishing fibrosis from sterilized metastasis vs uninvolved node architecture. Integrating cytokeratin immunohistochemistry, molecular profiling of treatment response, and oxidative stress biomarkers could improve lymph node regression grade objectivity and reproducibility. Such a refined tool may help tailor adjuvant chemotherapy decisions, supporting more personalized treatment strategies for rectal cancer patients.