Lymph node regression grade as a prognostic marker in rectal cancer after neoadjuvant therapy and radical resection

doi:10.3748/wjg.v32.i15.116026

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World Journal of Gastroenterology

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1007-9327

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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA

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Copyright: ©Author(s) 2026. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution-NonCommercial (CC BY-NC 4.0) license. No commercial re-use. See permissions. Published by Baishideng Publishing Group Inc.

World J Gastroenterol. Apr 21, 2026; 32(15): 116026
Published online Apr 21, 2026. doi: 10.3748/wjg.v32.i15.116026

Table 3 Association of lymph node regression grade with the factors relating to survival, n = 123

Patients characteristics	LRG	1	2	3	4	5	Value	P value
Gender							χ²_cmh = 0.78	0.38
Male	88	43 (48.86)	4 (4.55)	10 (11.36)	9 (10.23)	22 (25.00)
Female	35	17 (48.57)	5 (14.29)	4 (11.43)	4 (11.43)	5 (14.29)
Age (years)							χ²_cmh = 0.40	0.53
< 50	47	19 (40.43)	5 (10.64)	7 (14.89)	7 (14.89)	9 (19.15)
≥ 50	76	41 (53.95)	4 (5.26)	7 (9.21)	6 (7.89)	18 (23.68)
Post-CRT CEA (ng/mL)							χ²_cmh = 9.85	0.002
< 5	94	53 (56.38)	7 (7.45)	11 (11.70)	5 (5.32)	18 (19.15)
≥ 5	29	7 (24.14)	2 (6.90)	3 (10.34)	8 (27.59)	9 (31.03)
Post-CRT CA19-9 (U/mL)							χ²_cmh = 2.53	0.11
< 37	113	56 (49.56)	9 (7.96)	14 (12.39)	12 (10.62)	22 (19.47)
≥ 37	10	4 (40.00)	0 (0)	0 (0)	1 (10.00)	5 (50.00)
Distance from anal verge (cm)							χ²_cmh = 1.12	0.29
< 5	68	37 (54.41)	4 (5.88)	7 (10.29)	6 (8.82)	14 (20.59)
≥ 5	55	23 (41.82)	5 (9.09)	7 (12.73)	7 (12.73)	13 (23.64)
Operation							χ²_cmh = 0.20	0.66
LAR	83	39 (46.99)	6 (7.23)	11 (13.25)	8 (9.64)	19 (20.89)
APR	40	21 (52.50)	3 (7.50)	3 (7.50)	5 (12.50)	8 (20.00)
cTNM							χ²_cmh = 2.14	0.34
I	9	6 (77.78)	0 (0)	0 (0)	1 (11.11)	1 (11.11)
II	28	14 (50.00)	0 (0)	4 (14.29)	4 (14.29)	6 (21.43)
III	49	19 (38.78)	7 (14.29)	7 (14.29)	4 (8.16)	12 (24.49)
ypT							χ²_cmh = 16.33	< 0.0001
ypT0	13	10 (76.92)	1 (7.69)	1 (7.69)	1 (7.69)	0 (0)
ypT1	4	3 (75.00)	0 (0)	1 (25.00)	0 (0)	0 (0)
ypT2	27	20 (74.07)	1 (3.70)	1 (3.70)	3 (11.11)	2 (7.41)
ypT3	77	27 (35.06)	7 (9.09)	11 (14.29)	9 (11.69)	23 (29.87)
ypT4	2	0 (0)	0 (0)	0 (0)	0 (0)	2 (100.00)
ypN¹							χ²_cmh = 85.92	< 0.0001
ypN0	60	60 (100.00)	0 (0)	0 (0)	0 (0)	0 (0)
ypN1	35	0 (0)	6 (17.14)	9 (25.71)	10 (28.57)	10 (28.57)
ypN2	28	0 (0)	3 (10.71)	5 (17.86)	3 (10.71)	17 (60.71)
Tumor differentiation degree							χ²_cmh = 7.74	0.005
Well/moderate	104	56 (53.85)	7 (6.73)	11 (10.58)	12 (11.54)	18 (17.31)
Poor	19	4 (21.05)	2 (10.53)	3 (15.79)	1 (5.26)	9 (47.37)
TRG							χ²_cmh = 6.16	0.01
TRG1	13	10 (76.92)	1 (7.69)	1 (7.69)	1 (7.69)	0 (0)
TRG2	20	11 (55.00)	4 (20.00)	3 (15.00)	0 (0)	2 (10.00)
TRG3	44	18 (40.91)	3 (6.82)	6 (13.64)	4 (9.09)	13 (29.55)
TRG4	32	13 (40.63)	1 (3.13)	4 (12.50)	6 (18.75)	8 (25.00)
TRG5	14	8 (57.14)	0 (0)	0 (0)	2 (14.29)	4 (28.57)

¹Lymph node regression grade scores greatly depend on positive lymph nodes. Thus, the influence of ypN stage seems less significant in this analysis.

LRG: Lymph node regression grade; CRT: Chemoradiotherapy; CEA: Carcinoembryonic antigen; CA19-9: Carbohydrate antigen 19-9; LAR: Low anterior resection; APR: Abdominoperineal resection; cTNM: Clinical tumor-node-metastasis; TRG: Tumor regression grade; cmh: Cochran-Mantel-Haenszel.

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Citation: Shi YJ, Duan PP, Liu QQ, Ru HY, Huang YJ, Xia W, Chen L, Li X. Lymph node regression grade as a prognostic marker in rectal cancer after neoadjuvant therapy and radical resection. World J Gastroenterol 2026; 32(15): 116026
URL: https://www.wjgnet.com/1007-9327/full/v32/i15/116026.htm
DOI: https://dx.doi.org/10.3748/wjg.v32.i15.116026

Shi YJ, Duan PP, Liu QQ, Ru HY, Huang YJ, Xia W, Chen L, Li X. Lymph node regression grade as a prognostic marker in rectal cancer after neoadjuvant therapy and radical resection. World J Gastroenterol 2026; 32(15): 116026 [DOI: 10.3748/wjg.v32.i15.116026]

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