Perioperative clinical pathomorphologic evaluation of pararectal lymph node status and its contribution to definitive decision for local excision of rectal cancer

: On the basis of 669 patients with rectal carcinoma, who underwent radical surgery, we evaluated by means of discriminant statistics the prognostic value of 7 factors concerning lymph node involvement. By stratifying for important prognostic factors (level of differentiation, lymphocytic stromal reaction, depth of tumour infiltration) we have revealed 3 different groups: I--no or rare lymph node metastases; II--more frequent metastases but confined to "N1", and III--numerous distant metastases classified as "N2-3". On the basis of these results the final decision for local extirpation of the tumour with curative intention is made easier.