ONCOmmunity

MRI Lymph Node Evaluation for Prediction of Metastases in Rectal Cancer.

By: Karin Almlöv, Mischa Woisetschläger, Per Loftås, Olof Hallböök, Nils O Elander, Per Sandström

Department of Biomedical and Clinical Sciences, Division of Surgery, Linköping University, Norrköping, Sweden karin.almlov@liu.se.
2020-03-08; doi: 10.21873/anticanres.14247

Abstract

Aim

To explore whether the size and characteristics of the largest regional lymph node in patients with rectal cancer, based on magnetic resonance imaging (MRI), following neoadjuvant therapy and before surgery, is able to identify patients at high risk of developing metachronous metastases.

Patients

A retrospective case-control study with data from the Swedish Colo-Rectal Cancer Registry. Forty patients were identified with metachronous metastases (M+), and 40 patients without metastases (M0) were matched as controls.

Results

Patients with M+ disease were more likely to have a regional lymph node measuring ≥5 mm than patients with M0. (87% vs. 65%, p=0.02). There was also a significant difference between the groups regarding the presence of an irregular border of the largest lymph node (68% vs. 40%, p=0.01).

Conclusion

Lymph nodes measuring ≥5 mm with/without displaying irregular borders at MRI performed after neoadjuvant therapy emerged as risk factors for metachronous metastases in patients with rectal cancer. Intensified follow-up programmes may be indicated in these patients.