The correlation of total lymph nodes dissected and that of negative lymph nodes to the prognosis of patients with stage Ⅲ rectal carcinoma undergoing radical resection / 中华普通外科杂志

ABSTRACT

Objective To study retrospectively the relation of the number of all dissected and negative lymph nodes (LNs) to the prognosis of patients with stage Ⅲ rectal carcinoma after radical resection.Methods From 2002 to 2007,412 sage Ⅲ rectal carcinoma patients undergoing radical resection were enrolled.Patients were divided into five groups according to the number of dissected LNs as follows1 to 6 lymph nodes,7 to 12 lymph nodes,13 to 18 lymph nodes,19 to 24 lymph nodes,and more than 24 lymph nodes.The association with the survival was analyzed.The Kaplan-Meier method was used to estimate survival as a function of time,and survival differences were analyzed with the log-rank test.The correlation between all dissected and negative lymph nodes was analyzed.The Cox proportional hazard model were used to investigate the risk factors for stage Ⅲ rectal carcinoma.Results The 1,3 and 5 years survival rates were respectively 79.9％,59.2％ and 43.0％.The 5-year survival rates increased with the increasing number of the examined LNs and the negative LNs,the differences were significant (20.0％、26.5％ 、43.9％ 、54.2％ 、53.5％,P =0.001 ; 10.3％ 、34.8％ 、51.9％ 、56.8％ 、70.8％,P =0.000).There were 7301 LNs dissected among which 5698 were pathology negative.The dissected LNs were correlated positively with negative LNs on the Pearson's correlation test(correlation coefficients r =0.899).The total number of dissected LNs and negative LNs were independent prognostic predictors.Conclusions The total number of dissected lymph node and negative lymph nodes are significantly correlated to prognosis of staged Ⅲ rectal carcinoma patient.On premise of standard procedure,we see all dissected and negative lymph nodes as a prognostic auxiliary index.