# YpN0 rectal cancer patients with sterilized lymph nodes after neoadjuvant chemoradiotherapy are of greater risk of recurrence.

**Tumor:** Cáncer rectal
**Autores:** Manceau G, Margot N, Augustin J et al
**Revista:** Dig Liver Dis (2019)
**PMID:** 31427089 | **PMCID:** —
**DOI:** [10.1016/j.dld.2019.07.013](https://doi.org/10.1016/j.dld.2019.07.013)
**Fuente:** PubMed (abstract only)

## Relevancia
Tumor rectal post-quimiorradioterapia neoadyuvante: aporta evidencia sobre la conversión cN+ → ypN0 en el mesorrecto, valor pronóstico de la respuesta ganglionar y selección de pacientes para watch-and-wait u organ preservation. Paralelo al carcinoma de mama: la respuesta ganglionar tras NAC es un marcador pronóstico independiente y modula la cirugía locorregional.

## Abstract
Indication for adjuvant chemotherapy in ypN0 rectal cancer patients after chemoradiotherapy (CRT) is debated. The clinical significance of the presence of sterilized lymph nodes (LNS) in ypN0 patients remains to be determined.

To assess the prognostic value of LNS in ypN0 rectal cancers after neoadjuvant CRT.

From 2006-2016, 235 patients underwent TME surgery for non-metastatic mid-low rectal cancer after CRT. A lymph node was considered sterilized if there were signs of treatment response (fibrosis, necrosis or mucus) without residual tumor cells.

180 patients (77%) were classified ypN0 and 55 (23%) ypN+. LNS was present in 20 patients (9%). In ypN0 patients, 5-year OS was similar between patients with and without LNS. In contrast, 5-year DFS was significantly lower in ypN0/LNS&#x202f;+&#x202f;patients (58% vs. 78%, p&#x202f;=&#x202f;0.043) and was similar to those staged ypN+. In multivariate analysis, two factors were independent predictors of DFS: mesorectal grading (OR&#x202f;=&#x202f;3.14; 95%CI: 1.10-8.34; p&#x202f;=&#x202f;0.033) and the presence of LNS (OR&#x202f;=&#x202f;3.93, 95% CI: 1.06-11.81, p&#x202f;=&#x202f;0.042) CONCLUSION: The presence of LNS in ypN0 rectal cancer after neoadjuvant CRT is associated with an increased risk of recurrence and may be taken into account for the discussion of adjuvant chemotherapy.

## Acceso
Vía [DOI](https://doi.org/10.1016/j.dld.2019.07.013) o suscripción institucional.

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*Datos de PubMed. Citar: doi 10.1016/j.dld.2019.07.013*
