Pathological Nodal Staging Score for Rectal Cancer Patients Treated with Radical Surgery With or Without Neoadjuvant Therapy:A Postoperative Decision Tool
Purpose Our study aimed to help establish the standard of the minimum number of lymph nodes examined for rectal cancer,by estimating the probability that a pathologically node-negative patients has,indeed,free of positive nodes.Experiment Design 31,853 eligible patients with stage Ⅰ-Ⅲ adenocarcinoma of the rectum between 2004 and 2013 were identified from the Surveillance,Epidemiology and End Results(SEER)database.Patients were categorized into two groups: those treated with surgery directly(SURG)and those treated with neoadjuvant therapy(NEO).Nodal staging score(NSS)was developed based on pT/ypT stage and the number of nodes examined by using a beta-binomial model.Results In both cohorts,the probability of missing a positive node was estimated to approximately 16%if 12 are examined,but drops to around 10%when 20 nodes are examined.In SURG cohort,to rule out 90%possibility of false staging,three,seven,28,and 32 lymph nodes would need to be examined for patients with pT1-4 disease,respectively.While in NEO cohort,four,seven,12,and 16 lymph nodes would need to be examined for patients with ypT1-4 disease to guarantee an NSS of 90%.Conclusions Our study developed a model to estimate of false node-negative rate as a function of pathological tumor stage and number of lymph nodes examined.By determining whether a node-negative rectal cancer patient is adequately staged,NSS may serve as an instrument to assist in tailoring postoperative management and surveillance for patient with rectal cancer.
Nodal staging score rectal cancer lymph node neoadjuvant therapy beta-binomial model
Yaqi Li Weixing Dai Zhenyu Wu Yang Feng Ye Xu Sanjun Cai Qingguo Li Guoxiang Cai
Department of Colorectal Surgery,Fudan University Shanghai Cancer Center,Shanghai 200032,China;Depar Department of Biostastistics,School of Public Health Safety,Ministry of Education,Fudan University,S
国内会议
北京
英文
1-21
2017-05-19（万方平台首次上网日期，不代表论文的发表时间）