Prognostic Value of Negative Lymph Nodes (NLN) in Rectal Adenocarcinoma

We studied the impact on prognosis by negative LN (NLN) harvest count on rectal cancer patients, using immunohistochemistry to exclude micrometastasis in nodes negative by hematoxylin and eosin (H & E) stain. A prospective study including 114 patients in Mansoura university hospitals between 2005-2008 aged 18 years or older who were diagnosed as having localized invasive adenocarcinoma rectum with stage I, II & III was conducted. Close follow up done in both surgery department and department of clinical oncology and nuclear medicine for 5 years. We examined patient survival in relation to the negative lymph node count. Our results revealed that the number of negative lymph nodes could affect significantly survival curves where the disease free survival and overall survival were significantly better among the group of patients with more than ten negative LNs (P=0.021 & 0.012 respectively). In conclusion, the negative lymph node count is associated with improved survival of rectal cancer patients.