Prognostic value of lateral lymph node metastasis in pretreatment MRI for rectal cancer in patients undergoing neoadjuvant chemoradiation followed by surgical resection without lateral lymph node dissection: A systemic review and meta-analysis Review

  

Authors:	Lee, T.; Horvat, N.; Gollub, M. J.; Garcia-Aguilar, J.; Kim, T. H.
Review Title:	Prognostic value of lateral lymph node metastasis in pretreatment MRI for rectal cancer in patients undergoing neoadjuvant chemoradiation followed by surgical resection without lateral lymph node dissection: A systemic review and meta-analysis
Abstract:	Purpose: To systematically review and meta-analyze the prognostic significance of lateral lymph node metastasis (LLNM) on pretreatment MRI in patients with rectal cancer who undergo neoadjuvant chemoradiation followed by curative surgical resection without lateral lymph node dissection (LLND). Methods: We searched the MEDLINE and EMBASE databases until September 27, 2023, utilizing the following search terms: (rectal OR rectum OR colorectal) AND (lateral OR sidewall) AND (lymph OR node). The QUIPS tool was employed to evaluate methodological quality. We pooled the association between LLNM on pretreatment MRI and outcomes such as local recurrence, distant metastasis, disease-free survival, and overall survival using hazard ratio (HR) and odds ratio (OR) based on random effects model. Results: We included 9 studies, encompassing 3180 patients. LLNM on pretreatment MRI revealed a significant association with increased local recurrence rates (HR: 4.11; 95 % CI: [1.87, 9.02]) and elevated risks for both disease-free (HR: 1.70; 95 % CI: [1.42, 2.03]) and overall survival (HR: 1.76; 95 % CI: [1.44, 2.15]). As for distant metastasis, our analysis indicated a potential trend towards increased rates, though this did not reach statistical significance (HR: 1.67; 95 % CI: [0.85, 3.27]). Conclusions: Our findings underscore the relationship between LLNM and increased local recurrence and compromised disease-free and overall survival. This emphasizes the potential limitations of relying solely on neoadjuvant chemoradiation and highlights the potential need to intensify treatment in select patients. © 2024
Keywords:	survival analysis; cancer surgery; overall survival; review; cancer recurrence; disease free survival; nuclear magnetic resonance imaging; magnetic resonance imaging; lymph node metastasis; lymph node dissection; metastasis; distant metastasis; systematic review; rectum cancer; meta analysis; rectal cancer; meta-analysis; neoadjuvant chemoradiotherapy; lymph node metastases; prognosis; human; lateral lymph node dissection; lateral lymph node metastasis
Journal Title:	European Journal of Radiology
Volume:	178
ISSN:	0720-048X
Publisher:	Elsevier B.V
Date Published:	2024-09-01
Start Page:	111601
Language:	English
DOI:	10.1016/j.ejrad.2024.111601
PROVIDER:	scopus
PUBMED:	38972182
DOI/URL:	https://www.scopus.com/inward/record.uri?eid=2-s2.0-85197637346&doi=10.1016%2fj.ejrad.2024.111601&partnerID=40&md5=30af2b67059a43818a16e4cba7e8f578
Notes:	The MSK Cancer Center Support Grant (P30 CA008748) is acknowledge in the PDF -- Corresponding authors is MSK author: Tae-Hyung Kim -- Source: Scopus

https://synapse.mskcc.org/synapse/works/has_related_data_chk/217469