Abstract
Introduction
It is critical to accurately predict the occurrence of lateral pelvic lymph node (LPN)
metastasis. Currently, verified predictive tools are unavailable. This study aims
to establish nomograms for predicting LPN metastasis in patients with rectal cancer
who received or did not receive neoadjuvant chemoradiotherapy (nCRT).
Materials and methods
We carried out a retrospective study of patients with rectal cancer and clinical LPN
metastasis who underwent total mesorectal excision (TME) and LPN dissection (LPND)
from January 2012 to December 2019 at 3 institutions. We collected and evaluated their
clinicopathologic and radiologic features, and constructed nomograms based on the
multivariable logistic regression models.
Results
A total of 472 eligible patients were enrolled into the non-nCRT cohort (n = 312)
and the nCRT cohort (n = 160). We established nomograms using variables from the multivariable
logistic regression models in both cohorts. In the non-nCRT cohort, the variables
included LPN short diameter, cT stage, cN stage, histologic grade, and malignant features,
and the C-index was 0.930 in the training cohort and 0.913 in the validation cohort.
In the nCRT cohort, the variables included post-nCRT LPN short diameter, ycT stage,
ycN stage, histologic grade, and post-nCRT malignant features, and the C-index was
0.836 in the training dataset and 0.827 in the validation dataset. The nomograms in
both cohorts were moderately calibrated and well-validated.
Conclusions
We established nomograms for patients with rectal cancer that accurately predict LPN
metastasis. The performance of the nomograms in both cohorts was high and well-validated.
Keywords
Abbreviations:
(LPN) (Lateral pelvic lymph node), (LPND) (Lateral pelvic lymph node dissection), (mrEMVI) (MRI-detected extramural venous invasion), (nCRT) (Neoadjuvant chemoradiotherapy), (TME) (Total mesorectal excision), (JSCCR) (Japanese Society for Cancer of the Colon and Rectum), (cCRM) (Clinical circumferential resection margin), (AJCC) (American Joint Committee on Cancer), (AV) (Anal verge), (ROC) (Receiver operating characteristics), (AUC) (Area under the curve)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: December 29, 2022
Accepted:
December 24,
2022
Received in revised form:
October 24,
2022
Received:
June 12,
2022
Publication stage
In Press Journal Pre-ProofIdentification
Copyright
© 2022 Elsevier Ltd, BASO ~ The Association for Cancer Surgery, and the European Society of Surgical Oncology. All rights reserved.
