Diseases of the colon and rectum
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The current recommendation from the American Joint Committee on Cancer and the International Union Against Cancer is that 12 or more lymph nodes should be examined to appropriately stage rectal cancer. It is unclear if this metric is appropriate or achievable for patients who receive neoadjuvant therapy. ⋯ Patients with rectal cancer who receive preoperative chemoradiotherapy should be anticipated to have a lower lymph node yield than patients who receive surgery alone. This calls into question if the current guideline of 12 lymph nodes is relevant, in particular, for those patients receiving neoadjuvant therapy.