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Clinicopathological Factors and Nomogram Development for Predicting Lymph Node Metastasis in Locally Advanced Rectal

Xu Sun1,2,3, Rui Li1,2,3, Hao Liu1,2,3

  • 1School of Medicine, Nankai University, Tianjin.

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Summary

This study identified key risk factors for lymph node metastasis (LNM) in locally advanced rectal cancer (LARC). A predictive nomogram was developed to aid in clinical decision-making for LARC patients.

Keywords:
locally advanced rectal cancerlymph node metastasisnomogrampredictive modelrisk factors

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Area of Science:

  • Oncology
  • Surgical Oncology
  • Gastrointestinal Oncology

Background:

  • Lymph node metastasis (LNM) in locally advanced rectal cancer (LARC) is a critical prognostic factor.
  • Understanding LNM predictors is essential for optimizing perioperative treatment strategies.

Purpose of the Study:

  • To identify clinicopathological factors associated with LNM in LARC patients.
  • To develop and validate a predictive nomogram for LNM in LARC.

Main Methods:

  • Retrospective analysis of 1270 LARC patients undergoing radical surgery.
  • Univariate and multivariate logistic regression to identify LNM predictors.
  • Nomogram construction and internal validation using bootstrap resampling.

Main Results:

  • LNM detected in 47.0% of patients.
  • Independent risk factors: mucinous adenocarcinoma, bowel obstruction, poor differentiation, perineural invasion, lymphovascular invasion (LVI).
  • Protective factors: alcohol consumption, microsatellite instability-high (MSI-H) status. Ki-67 for stage N2.

Conclusions:

  • Key risk factors for LNM in LARC were elucidated.
  • A predictive nomogram was developed for clinical application.
  • Findings support multidisciplinary perioperative treatment planning for LARC.