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Background/aim To investigate the impact of inguinal lymph node dissection (ILND) following neoadjuvant chemoradiotherapy (NACRT) for rectal cancer patients with ILN metastasis. Patients and methods Forty-three patients with rectal cancer underwent NACRT followed by curative surgery between January 2005 and December 2016. Seven patients underwent ILND after NACRT for clinically-positive ILN metastasis (ILND (+) group), while the remaining 36 did not receive ILND for clinically negative ILN metastasis (ILND (-) group). Their outcomes were retrospectively analyzed. Results Only one patient in the ILND (+) group had a local recurrence at six years after surgery. The 5-year recurrence-free survival was 100% and 65.4% in the ILND (+) and ILND (-) groups, respectively (p=0.09), and the 5-year overall survival was 100% and 83.2%, respectively (p=0.32). Conclusion ILND following NACRT seems effective for rectal cancer patients with ILN metastasis.

Background It was recently reported that expression of prospero homeobox protein-1 (PROX1) is correlated with the prognosis of esophageal cancer and colorectal cancer. However, its correlation with gastric cancer is unclear. Materials and methods Our study analyzed the effect of PROX1 knockdown on the migration, invasion and proliferation of the MKN45 human gastric cancer cell line. The correlation between PROX1 expression levels and clinicopathological factors were also analyzed in tumor samples from 99 patients with gastric cancer. Results Migration, invasion and proliferation were significantly reduced in MKN45 cells with PROX1 knockdown. PROX1 expression was detected in gastric cancer tissues at various levels. PROX1 expression levels were positively correlated with cancer stage, N factor, lymphatic vascular invasion, and vascular invasion in patients with gastric cancer. Analysis of overall and recurrence-free survival indicated that high PROX1 expression was significantly correlated with poor prognosis. Conclusion PROX1 can be an indicator of poor prognosis and a molecular target for gastric cancer treatment.

A 27-year-old woman was diagnosed with gastric cancer complicated peritoneal dissemination and direct invasion to pancreas via staging laparoscopy. After systemic chemotherapy using regimen of S-1/CDDP for 2courses, the tumor did not increase in size and peritoneal dissemination did not progress. The patient subsequently underwent distal gastrectomy as a curative surgery. The histological diagnosis was ypT4bN1M0, ypStage III B. The patient was treated with DOC/CDDP for 6 courses after surgery as adjuvant therapy. At present 6 years after surgery, the patient is alive without tumor recurrence.

No consensus has been reached with regard to the optimal treatment strategy and the prognosis of patients with advanced rectal cancer and inguinal lymph node metastasis. We, therefore, retrospectively analyzed the outcomes of 41 patients with locally advanced rectal cancer who underwent surgery after neoadjuvant chemoradiotherapy(NACRT). Six patients, with clinical inguinal lymph node metastasis determined by pretreatment imaging, underwent inguinal lymph node dissections after NACRT. Five patients survived without a relapse. Only 1 patient, who had been diagnosed with pathological inguinal lymph node metastasis, had a relapse in the right iliac lymph node 6 years after surgery. Surgical treatment after NACRT for rectal adenocarcinoma with inguinal lymph node metastasis contributes to an improvement in outcomes. NACRT plus inguinal lymph node dissection is an effective strategy for patients with inguinal lymph node metastasis from rectal adenocarcinoma.