Japan Digestive Disease Week 2025
International Poster Session6 (JDDW)
October 31, 10:10–10:42, Room 15 (Kobe International Exhibition Hall No.1 Building Digital Poster Venue)
IP-29_S
Local re-recurrence and survival after salvage surgery for isolated lateral lymph node recurrence in rectal cancer
- 1
- Department of Gastroenterological Surgery, Aichi Cancer Center Hospital
- 2
- Chulalongkorn Colorectal Research Unit, Faculty of Medicine, Chulalongkorn University
- 3
- Chakri Naruebodindra Medical Institute, Faculty of Medicine Ramathibodi Hospital, Mahidol University
Background
Isolated lateral lymph node recurrence (LLNR) after primary curative resection is a significant clinical challenge. Understanding the risk factors affecting the prognosis might develop an effective treatment.
Methods
We conducted a retrospective international collaborative study involving isolated LLNR patients who underwent salvage surgery at tertiary cancer centers in Japan and Thailand between 2013 and 2024.
Results
Thirty-four patients were included with a median follow-up of 55.8 months. After salvage surgery, 25 (73.5%) patients developed re-recurrence, and 15 (44.1%) patients were local re-recurrence. 5-year overall survival (OS) was 70%, 5-year recurrence-free survival (RFS) was 24%, and 5-year cumulative risk of local re-recurrence was 48%, respectively. AJCC stage IV at primary surgery was associated with significantly worse OS (HR 1.77, p=0.029) and RFS (HR 1.45, p=0.036). Lateral lymph node (LLN) size >=17 mm affected the OS (HR 5.05, p=0.039). The local re-recurrence rate was higher at age >=65 (HR 3.11, p=0.053) and internal iliac lymph recurrence (HR 6.13, p=0.082).
Conclusions
AJCC stage IV at primary surgery and LLN size >=17 mm may be associated with worse survival outcomes, while age >=65 years and internal iliac node recurrence might be the risk of local re-recurrence.
Isolated lateral lymph node recurrence (LLNR) after primary curative resection is a significant clinical challenge. Understanding the risk factors affecting the prognosis might develop an effective treatment.
Methods
We conducted a retrospective international collaborative study involving isolated LLNR patients who underwent salvage surgery at tertiary cancer centers in Japan and Thailand between 2013 and 2024.
Results
Thirty-four patients were included with a median follow-up of 55.8 months. After salvage surgery, 25 (73.5%) patients developed re-recurrence, and 15 (44.1%) patients were local re-recurrence. 5-year overall survival (OS) was 70%, 5-year recurrence-free survival (RFS) was 24%, and 5-year cumulative risk of local re-recurrence was 48%, respectively. AJCC stage IV at primary surgery was associated with significantly worse OS (HR 1.77, p=0.029) and RFS (HR 1.45, p=0.036). Lateral lymph node (LLN) size >=17 mm affected the OS (HR 5.05, p=0.039). The local re-recurrence rate was higher at age >=65 (HR 3.11, p=0.053) and internal iliac lymph recurrence (HR 6.13, p=0.082).
Conclusions
AJCC stage IV at primary surgery and LLN size >=17 mm may be associated with worse survival outcomes, while age >=65 years and internal iliac node recurrence might be the risk of local re-recurrence.
- Index Term 1: Isolated lateral lymph node recurrence
- Index Term 2: Salvage lateral lymph node dissection