Good and complete responding locally advanced rectal tumors after chemoradiotherapy: where are the residual positive nodes located on restaging MRI?
Abdom Radiol (NY)
; 41(7): 1245-52, 2016 07.
Article
en En
| MEDLINE
| ID: mdl-26814499
ABSTRACT
PURPOSE:
Aim of this study was to evaluate the distribution of persistent mesorectal lymph node metastases on restaging MRI in patients with a good or complete response of their primary tumor (ypT0-2) after CRT for locally advanced rectal cancer.METHODS:
Two hundred and twenty eight locally advanced rectal cancer patients underwent CRT, which resulted in a good response (downstaging to yT0-2) in 144 patients. Forty-nine patients were excluded (no surgery/insufficient follow-up or lacking lesion-by-lesion histology results). This resulted in a final study group of 95 yT0-2 patients. For the patients with a yN(+)-status, a detailed lesion-by-lesion comparison between restaging MRI and histology was performed to evaluate the characteristics and distribution of the individual N(+)-nodes.RESULTS:
7/95 patients (7%) had a yT0-2N(+) status (11/880 (1%) N(+) nodes) no N(+) were found below the tumor level, 55% of the N(+) nodes were located at the level of the tumor, and 45% proximal to the tumor (at a median distance of 1.4 cm above the tumor level). In axial plane, 82% of the nodes were located at the ipsilateral circumference of the tumor, at a median distance of 0.9 cm from the tumor/rectal wall.CONCLUSIONS:
The incidence of persistent metastatic mesorectal nodes after CRT in patients with a good tumor response after CRT is very low. No N(+) nodes are found below the tumor level. All N(+) nodes are located at the level of or proximal to the primary tumor, of which the majority very close to the tumor/lumen.Palabras clave
Texto completo:
1
Colección:
01-internacional
Asunto principal:
Neoplasias del Recto
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Imagen por Resonancia Magnética
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Quimioradioterapia
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Metástasis Linfática
Tipo de estudio:
Observational_studies
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Risk_factors_studies
Límite:
Adult
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Aged
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Aged80
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Female
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Humans
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Male
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Middle aged
Idioma:
En
Revista:
Abdom Radiol (NY)
Año:
2016
Tipo del documento:
Article
País de afiliación:
Países Bajos