AIMS: To determine the prognostic significance of the nodal stage and number of nodes recovered in the surgical specimen after preoperative @entity7158 ( @entity7158 ) and surgery for locally advanced or unresectable @entity5 . MATERIALS AND METHODS: One hundred and eighty-two consecutive @entity1 with locally advanced or unresectable (T3/T4) rectal carcinomas were entered on a prospective database and treated in this department with preoperative chemoradiation, followed 6-12 weeks later by surgical resection. Most @entity1 received chemotherapy in the form of low-dose @entity4181 and @entity1487 ( @entity1487 ) 350 mg/m2 via a 60-min infusion on days 1-5 and 29-33 of a course of pelvic radiotherapy delivered at a dose of 45 Gy in 25 fractions over 33 days to a planned volume. After resection, @entity1 with a positive circumferential margin (< or = 1 mm), extranodal deposits or Dukes' C histology received adjuvant @entity1487 -based-chemotherapy (n = 40). RESULTS: After @entity7158 , 161 @entity1 underwent resection. Twenty-one @entity1 remained unresectable or refused an exenterative operation. Median follow-up is 36 months. Down-staging was achieved in most @entity1 , with 19 having a complete pathological response (pT0). The median number of lymph nodes recovered for all @entity1 was five (range 0-21). The 3-year survival rate for node-positive @entity1 is 47%, for node-negative @entity1 with less than three lymph nodes recovered is 62% and for node-negative @entity1 with three or more lymph nodes recovered is 70%. Compared with node-positive @entity1 , simple regression models revealed a reduced hazard ratio (HR) of 0.72 (0.36-1.43) for node-negative @entity1 with less than three nodes recovered and 0.48 (0.26-0.89) for node-negative @entity1 with three or more lymph nodes recovered. In a multivariate model, including nodal status, excision status, age and sex only positive excision margins significantly predicted a poor outcome: HR = 3.05 (1.55-5.97). CONCLUSIONS: The number of nodes found after preoperative chemoradiation is a significant prognostic factor by univariate analysis. In this study, @entity1 with node-negative histology, and at least three nodes recovered, had better long-term survival than @entity1 in whom two or less nodes were recovered or with positive nodes. This effect was attenuated by the inclusion of excision status in multivariate models.

The reliability of lymph-node staging in XXXX after preoperative chemoradiotherapy.

@entity1 :: ('9606', 'Species') :: ['patients'] @entity4181 :: ('MESH:D002955', 'Chemical') :: ['folinic acid'] @entity7158 :: ('MESH:D009378', 'Disease') :: ['synchronous chemoradiation', 'SCRT'] @entity5 :: ('MESH:D009369', 'Disease') :: ['rectal cancer'] @entity1487 :: ('MESH:D005472', 'Chemical') :: ['5-FU', '5-fluorouracil']
@entity5 :: (MESH:D009369,Disease) :: ['rectal cancer']
