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8%) patients with positive LPLN had downsized to Verteporfin mm; range, 0�C45 mm; P=0.009). Rectal resection was performed in 103 patients, and grade ��2 response was confirmed in 38 (36.5%) patients. These primary tumor responders were not correlated with LPLN-positive status before and after CRT, but were correlated with a lower rate of pathological mesorectal lymph node (MLN) metastasis (10.5 vs. 47.0%; P=0.0002). Although the CRT effect were not significantly correlated with LPLN-positive status and primary tumor, the LPLN-positive group had significantly more cases of pathological MLN metastasis compared with the LPLN-negative group (2.4 vs. 0.8, respectively; P=0.008). The patient and tumor characteristics according to LPLN-positive status after preoperative CRT are shown in Table III. More MLN metastases were found in the LPLN-positive group after preoperative CRT (3.7 vs. 0.7; PVandetanib order outcomes The median follow-up period was 52.2 months (range, 5.7�C154.3 months). Of the 103 patients who underwent primary resection, recurrence developed in 27 patients, including local recurrence in 7 (6.8%) and Itraconazole distant recurrence in 20 (19.4%) patients. The 5-year cancer-specific survival (CSS) and relapse-free survival (RFS) did not differ significantly between patients with and without positive LPLN on pretreatment imaging (82.6 vs. 83.4% and 75.2 vs. 56.6%, respectively). However, LPLN-positive status after CRT was significantly associated with poor 5-year CSS (72.9 vs. 84.8%; P=0.005) and RFS (32.4 vs. 77.1%; P=0.04) (Fig. 1). For the entire cohort, the 3-year cumulative local recurrence rates were 12.5% in the LPLN-positive and 2.8% in the LPLN-negative groups after CRT. The univariate analysis identified cT4, LPLN-positive status after CRT, pMLN metastasis and high serum CEA level as significant predictors of poor CSS. The multivariate analysis demonstrated that pMLN metastasis and cT4, but not enlarged LPLN, were independent prognostic factors for CSS [odds ratio (OR) = 3.72, 95% confidence interval (CI): 1.34�C10.31, P=0.01; and OR=3.65, 95% CI: 1.28�C10.42, P=0.02, respectively] in patients with RC who received preoperative CRT (Table IV). Also, CRM positivity, cT4 and pMLN metastasis were significant predictors of RFS in the univariate analysis, and pMLN metastasis was an independent prognostic factor for RFS in the multivariate analysis (OR=4.61, 95% CI: 2.00�C10.53, P=0.0003) (Table IV).