Artikel
Acetone Compression is Highly Efficient for Optimal Lymph Node Harvest in UICC Stage II and III Rectal Cancer Treated by Neoadjuvant Radiochemotherapy (RCT)
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Veröffentlicht: | 20. Mai 2011 |
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Gliederung
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Introduction: For reliable postoperative staging after neoadjuvant RCT, adjuvant therapy decision and prediction of survival the number of examined lymph nodes (LN) is of utmost importance in rectal cancer. Recently, the median number of LN found has been described as 7.0 (Mekenkamp et al. AJSP 2009). We hypothezise that high quality of total mesorectal excision (TME) and of pathological work-up are key-determinants of sufficient LN retrieval.
Materials and methods: In the present study the efficiency of four different LN retrieval techniques in 257 rectal cancer specimens with and without neoadjuvant RCT was investigated and compared. We developed and validated a new acetone compression (AC) procedure that allowed the detection of any LN of the mesorectum in particular after RCT.
Results: We found that high quality TME combined with elution and compression of the whole perirectal fat is cost effective and the yield of LN is increased to 4-6x if compared to data of literature and to about 2x if compared with fat clearance (FC) procedures.
Conclusion: We hypothesize that neoadjuvant treatment does not change the number of LN in rectal cancer but rather the size. Thus, AC procedure is highly recommended as a method of choice suited for routine work-up of rectal cancer specimens especially after neoadjuvant RCT.