Diagnostic accuracy of lateral lymph node metastasis for locally advanced rectal cancer after neoadjuvant therapy: a systematic review and meta-analysis.

IF 2.9 3区医学 Q2 ONCOLOGY

Expert Review of Anticancer Therapy Pub Date : 2025-05-15 DOI:10.1080/14737140.2025.2506646

Kosuke Ozaki, Kazushige Kawai, Shimpei Ogawa, Yukihide Kanemitsu, Yoichi Ajioka

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Abstract

Background: The optimal criteria for lateral lymph node dissection (LLND) in rectal cancer following neoadjuvant therapy remain undefined. This systematic review and meta-analysis evaluated the diagnostic accuracy of lateral lymph node metastasis (LLNM) to refine criteria for selective LLND.

Research design and methods: A systematic search of PubMed, Embase, and the Cochrane Library (10 August 2024) identified studies assessing magnetic resonance imaging (MRI)-based LLNM detection in patients with rectal cancer who underwent neoadjuvant therapy and radical surgery. Studies reporting MRI-based LLNM assessments with pathological confirmation were included. Non-English studies, reviews, case reports, and those lacking lymph node size data were excluded. The risk of bias was assessed using QUADAS-2. Pooled sensitivity, specificity, and diagnostic odds ratios were estimated using hierarchical summary receiver operating characteristic curve (HSROC) analysis.

Results: Eleven studies met the inclusion criteria. All used MRI-based size assessments. The pooled sensitivity and specificity were 0.776 (95% CI: 0.639-0.872) and 0.694 (95% CI: 0.541-0.813), respectively, with an HSROC area under the curve (AUC) of 0.801.

Conclusions: MRI is the most widely used modality for diagnosing LLNM in rectal cancer patients who have undergone neoadjuvant therapy, with size criteria being the most commonly applied.

Registration: PROSPERO (CRD42024578499).

查看原文本刊更多论文

局部晚期直肠癌新辅助治疗后外侧淋巴结转移的诊断准确性：一项系统回顾和荟萃分析。

背景：直肠癌新辅助治疗后侧淋巴结清扫（LLND）的最佳标准尚不明确。本系统综述和荟萃分析评估了侧淋巴结转移（LLNM）的诊断准确性，以完善选择性LLND的诊断标准。研究设计和方法：对PubMed、Embase和Cochrane图书馆进行系统检索（2024年8月10日），确定了评估基于磁共振成像（MRI）的LLNM检测在接受新辅助治疗和根治性手术的直肠癌患者中的研究。研究报告了基于mri的LLNM评估和病理证实。非英语研究、综述、病例报告和缺乏淋巴结大小数据的研究被排除在外。偏倚风险采用QUADAS-2进行评估。使用分级汇总受试者工作特征曲线（HSROC）分析估计合并敏感性、特异性和诊断优势比。结果：11项研究符合纳入标准。所有人都使用了基于核磁共振成像的大小评估。合并敏感性和特异性分别为0.776 （95% CI: 0.639-0.872）和0.694 (95% CI: 0.541-0.813)， HSROC曲线下面积（AUC）为0.801。结论：在接受新辅助治疗的直肠癌患者中，MRI是诊断LLNM最广泛使用的方式，最常用的是大小标准。报名：普洛斯彼罗（CRD42024578499）。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Expert Review of Anticancer Therapy 医学-肿瘤学

CiteScore

5.10

自引率

3.00%

发文量

100

审稿时长

4-8 weeks

期刊介绍： Expert Review of Anticancer Therapy (ISSN 1473-7140) provides expert appraisal and commentary on the major trends in cancer care and highlights the performance of new therapeutic and diagnostic approaches. Coverage includes tumor management, novel medicines, anticancer agents and chemotherapy, biological therapy, cancer vaccines, therapeutic indications, biomarkers and diagnostics, and treatment guidelines. All articles are subject to rigorous peer-review, and the journal makes an essential contribution to decision-making in cancer care. Comprehensive coverage in each review is complemented by the unique Expert Review format and includes the following sections: Expert Opinion - a personal view of the data presented in the article, a discussion on the developments that are likely to be important in the future, and the avenues of research likely to become exciting as further studies yield more detailed results Article Highlights – an executive summary of the author’s most critical points.