TABLE 3.
Association of retroperitoneal and pelvic LN radiographic persistence with oncologic outcomes
| Univariate regression |
Multivariable regression |
|||
|---|---|---|---|---|
| HR (95% CI) | p value | HR (95% CI) |
p value | |
| RFS | ||||
| Age at diagnosis (median, IQR) | 0.98 (0.95–1.02) | .39 | ||
| Sex | ||||
| Male | Reference | |||
| Female | 1.00 (0.31–3.24) | .99 | ||
| Race | ||||
| White | Reference | |||
| Black | 2.11 (0.65–6.89) | .22 | ||
| Other | - | |||
| Functional status | ||||
| Independent | Reference | |||
| Partially dependent | - | |||
| Pretreatment stage (AJCC 8th ed) | ||||
| I | Reference | |||
| II | - | |||
| III | - | |||
| Pretreatment tumor location | ||||
| Lower rectum | Reference | |||
| Middle rectum | 0.61 (0.18–2.03) | .42 | ||
| Upper rectum | - | - | ||
| Neoadjuvant chemotherapy | ||||
| No | Reference | |||
| Yes | - | |||
| Neoadjuvant chemoradiation | ||||
| No | Reference | |||
| Yes | - | |||
| Total neoadjuvant therapy | ||||
| No | Reference | Reference | ||
| Yes | 0.86 (0.28–2.65) | .80 | 0.58 (0.17–2.01) | .39 |
| Operation type | ||||
| LAR | Reference | |||
| APR | 1.33 (0.44–4.01) | .61 | ||
| Approach | ||||
| Open | Reference | |||
| Minimally invasive | 0.32 (0.09–1.15) | .08 | ||
| Final margin status | ||||
| R0 | Reference | |||
| R1 | 2.2 (0.49–10.27) | .30 | ||
| LVI | ||||
| No | Reference | |||
| Yes | 1.75 (0.53–5.76) | .36 | ||
| PNI | ||||
| No | Reference | |||
| Yes | 1.76 (0.50–6.20) | .38 | ||
| Posttreatment LN disappearance/radiographic RLPN persistence | ||||
| 0 LN | Reference | Reference | ||
| ≥1 LN | 0.57 (0.18–1.77) | .33 | 0.44 (0.12–1.54) | .20 |
| OS | ||||
| Age at diagnosis (median, IQR) | 1.01 (0.96–1.07) | |||
| Sex | ||||
| Male | Reference | |||
| Female | 0.44 (0.11–1.77) | .25 | ||
| Race | ||||
| White | Reference | |||
| Black | 1.80 (0.36–9.95) | .47 | ||
| Other | - | |||
| Functional status | ||||
| Independent | Reference | |||
| Partially Independent | - | |||
| Pretreatment stage (AJCC 8th ed) | ||||
| I | Reference | |||
| II | - | |||
| III | - | |||
| Pretreatment tumor location | ||||
| Lower rectum | Reference | |||
| Middle rectum | 0.14 (0.02–1.15) | .07 | ||
| Upper rectum | - | |||
| Neoadjuvant chemotherapy | ||||
| No | Reference | |||
| Yes | - | - | ||
| Neoadjuvant chemoradiation | ||||
| No | Reference | |||
| Yes | 0.22 (0.03–1.99) | .18 | ||
| Total neoadjuvant therapy | ||||
| No | Reference | Reference | ||
| Yes | 0.49 (0.10–2.34) | .37 | 0.49 (0.10–2.45) | .38 |
| Operation type | ||||
| LAR | Reference | |||
| APR | 1.23 (0.30–4.95) | .77 | ||
| Approach | ||||
| Open | Reference | |||
| Minimally invasive | 0.56 (0.13–2.45) | .44 | ||
| Final margin status | ||||
| R0 | Reference | |||
| R1 | 4.19 (0.93–21.14) | .08 | ||
| LVI | ||||
| No | Reference | |||
| Yes | 5.62 (1.40–22.63) | .02 | ||
| PNI | ||||
| No | Reference | |||
| Yes | 1.2 (0.14–10.27) | .87 | ||
| Posttreatment LN disappearance/radiographic RLPN Persistence | ||||
| 0 LN | Reference | Reference | ||
| ≥1 LN | 1.20 (0.30–4.84) | .80 | 1.02 (0.25–4.26) | .97 |
Abbreviations: CI, confidence interval; APR, abdominoperineal resection; HR, hazard ratio; IQR, interquartile range; LAR, low anterior resection; LN, lymph node; LVI, lymphovascular invasion PNI, perineural invasion; RFS, recurrence-free survival; RLPN, retroperitoneal and lateral pelvic lymph nodes.