Neoadjuvant therapy for rectal cancer decreases the number of lymph nodes harvested in operative specimens
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Updated: May 14, 2026
Robot-assisted Total Mesorectal Excision and Lateral Pelvic Lymph Node Dissection for Locally Advanced Middle-low Rectal Cancer
Published on: February 12, 2022
Robert Amajoyi1, Yoori Lee, Patrick J Recio
1Department of Colorectal Surgery, c/o Colorectal Physicians & Surgeons of Pennsylvania, Saint Vincent, 145 West 23rd Street, Suite 201, Erie, PA 16502, USA.
Background:
We evaluated the effect of neoadjuvant therapy (NAT) on lymph node harvest in rectal cancer patients undergoing anatomic resection with curative intent.
Methods:
A prospectively maintained database was retrospectively queried for rectal cancer cases from 1990 to 2010. Demographic data, NAT, and lymph node yield were analyzed. Nonanatomic resections were excluded.
Results:
Five hundred two cases were identified; the mean age was 68 years (range 34-89), and 56% were men. One hundred fifty-one (30%) patients received NAT. Overall, the lymph node yield was diminished in proctectomy specimens after NAT (mean = 9, median = 7) compared with specimens without therapy (mean = 13, median = 10, P = .001). Age was not a significant factor in the lymph node yield (P = .213 and .329). Among patients treated with NAT, younger patients had a significantly lower lymph node yield (P < .0001).
Conclusions:
A decreased lymph node yield in proctectomy specimens from patients treated with NAT is consistent with prior studies. Younger patients had a greater reduction in lymph node harvest after NAT compared with senior patients.
