THE INFLUENCE OF THE NUMBER OF DISSECTED LYMPH-NODES ON LOCAL RECURRENCE OF RECTAL-CARCINOMA - A RESULT OF STAGE MIGRATION

In 386 patients with rectal carcinoma of UICC stage I-III operated on between 1 January 1985 and 31 December 1995 we investigated the influe nce of the number of dissected lymph nodes on tumor stage and local re currence retrospectively. We found a significant correlation between t he number of lymph nodes dissected and the number of detected lymph no de metastases. Following this result we found an increase in UICC stag e III (P = 0.013) and pTx pN2 tumors (P = 0.000) in correlation with t he number of dissected lymph nodes. Significantly lower rates of local recurrence were found only in UICC stage I and UICC stage II. Overall and in a multivariate analysis the number of dissected lymph nodes ha d no influence on local recurrence. It was shown that lower local recu rrence rates in UICC stage I and II did not depend on therapeutic bene fit but on stage migration because of more exact tumor staging. The in fluence of other surgical factors, especially total mesorectal excisio n, remains to be discussed.