Does obesity impact lymph node retrieval in colon cancer surgery?

Linebarger, Jared H.; Mathiason, Michelle A.; Kallies, Kara J.; Shapiro, Stephen B.

doi:10.1016/j.amjsurg.2009.12.012

Cited by 41 publications

(32 citation statements)

References 11 publications

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“…In our country, Zeren et al 12 in their study, classified 71 14 reported in their 142009 patients study that the number of excised lymph nodes in right colon tumors was higher in patients who had resections for colon cancer. Linebarger et al 8 also stated in their study that the number of excised lymph nodes was higher in right colon tumors when they compared the cases of right colectomy and left colectomy. The results of our study revealed that the number of excised lymph nodes in right colon tumors was higher than in the left colon and rectal tumors, and this was statistically significant (p=0.01).…”

Section: Discussionmentioning

confidence: 91%

“…Pimiento et al 7 concluded in their 127 patients retrospective study that BMI had no effect on the number of excised lymph nodes. Linebarger et al 8 in their study investigating the effects of obesity and tumor localization, tumor stage and pathological examination on the number of excised lymph nodes in patients who underwent surgery for colon cancer, reported that BMI did not affect the number of excised lymph nodes as well. In their 191 patients study.…”

Section: Discussionmentioning

confidence: 99%

“…Sufficient lymph node dissection and excision of the There is only a limited number of studies in literature investigating the effects of BMI on the number of excised lymph nodes in colorectal cancer surgery. 7,8,9,12,13 In general, the majority of studies have shown that BMI had no effect on the number of excised lymph nodes. Pimiento et al 7 concluded in their 127 patients retrospective study that BMI had no effect on the number of excised lymph nodes.…”

Section: Discussionmentioning

confidence: 99%

“…There are a limited number of studies investigating the effects of obesity on the number of excised lymph nodes in literature. 7,8,9 Therefore, our aim in this study was to investigate the effects of BMI on the number of excised lymph nodes in colorectal cancer surgery.…”

Section: Introductionmentioning

confidence: 99%

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Does Body Mass Index Affect the Number of Excised Lymph Nodes in Colorectal Cancer Surgery?

Çetin¹,

Gündeş²,

Çiyiltepe³

et al. 2017

TJCD

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Amaç: Bu çalışmada kolorektal kanser nedeniyle elektif cerrahi uygulanan hastalarda vücut kitle indeksinin (VKİ) çıkarılan toplam ve metastatik lenf nodu sayısına olan etkisi incelenmiştir. Yöntem: Çalışmamızda kolorektal kanser tanısıyla opere edilen 185 hasta geriye dönük olarak incelendi. Hastalar VKİ'ye göre üç gruba ayrıldı: 24,9 (kg/m 2 ) ve altında olanlar normal (grup 1), VKİ 25-30 (kg/m 2 ) arasında olanlar kilolu (grup 2) ve 30 (kg/m 2 ) üzerinde olanlar ise aşırı kilolu (grup 3). Daha sonra gruplar arasındaki değişkenler ve VKİ'nin çıkarılan toplam ve metastatik lenf nodu sayısına etkileri değerlendirildi. Bulgular: Grup 1'de 52 hasta, grup 2'de 73 ve grup 3'te ise 60 hasta mevcuttu. Gruplar arasında yaş, cinsiyet, tümör lokalizasyonu, tümör invazyonu (T evresi), çıkarılan lenf nodu sayısı, metastatik lenf nodu sayısı ve tümör evrelemesi açısından anlamlı farklılık saptanmadı. Çıkarılan lenf nodu sayısının sağ kolon tümörlerinde sol kolon ve rektum tümörlerine göre daha yüksek olduğu saptandı (p=0,01). Yapılan subgrup analizlerde rektum tümörlerinin daha ileri evrede olduğu (p=0,02) ve rektum tümörlerinde neoadjuvan almayan grupta çıkarılan lenf nodu sayısının anlamlı derecede yüksek olduğu bulundu (p=0,01). Sonuç: Sonuç olarak; obezite kolorektal kanser cerrahisinde çıkarılan toplam ve metastatik lenf nodu sayısını etkilememektedir. Cerrahlar VKİ yüksek olan hastalarda kolorektal kanser cerrahisi sırasında yeterli sayıda lenf nodu çıkaramama endişesinde olmamalıdırlar. Anahtar Kelimeler: Kolorektal kanser, vücut kitle indeksi, lenf nodu sayısı ÖZ ABSTRACTAim: This study investigated the effect of body mass index (BMI) on the total number of excised and metastatic lymph nodes in patients undergoing elective surgery for colorectal cancer. Method: The cases of 185 patients who were diagnosed with colorectal cancer were retrospectively analyzed. The patients were divided into three groups according to BMI: patients with BMI scores of 24.9 kg/m 2 and lower were designated as normal (group 1), those with BMI scores of 25-30 kg/ m 2 were overweight (group 2), and those with BMI scores higher than 30 kg/m 2 were obese (group 3). Following classification, differences in variables between the groups and the effects of BMI on the total number of excised and metastatic lymph nodes were evaluated. Results: There were 52 patients in group 1, 73 patients in group 2, and 60 patients in group 3. There were no statistically significant differences among the groups with regards to age, sex, tumor location, tumor invasion (T-stage), number of excised lymph nodes, number of metastatic lymph nodes, or tumor stage. The number of excised lymph nodes was found to be higher in right colon tumors than in left colon and rectal tumors (p=0.01). The results of the subgroup analyses revealed that rectal tumors were at a more advanced stage (p=0.02) and among patients with rectal tumors, significantly more lymph nodes were excised from patients in the non-neoadjuvant group (p=0.01). Conclusion: Our results led us to conclude that o...

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Section: Discussionmentioning

confidence: 91%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Does Body Mass Index Affect the Number of Excised Lymph Nodes in Colorectal Cancer Surgery?

Çetin¹,

Gündeş²,

Çiyiltepe³

et al. 2017

TJCD

View full text Add to dashboard Cite

show abstract

“…The method of searching for LNs in Japan is unique from other countries, where LN retrieval is performed by pathologists or pathological assistants on formaldehyde-fixed specimens (7,8). In most cases in Japan, surgeons search for the LNs immediately after surgery (before fixation).…”

Section: Introductionmentioning

confidence: 99%

Lymph node retrieval after dissolution of surrounding adipose tissue for pathological examination of colorectal cancer

et al. 2017

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Abstract. Examination of >12 lymph nodes (LNs) is important for the diagnostic accuracy of nodal status following resection of colorectal cancer. In the present study, the efficacy of a fat dissolution technique for LN retrieval was evaluated using resected colon and rectum mesentery. First, the resected mesentery was searched for LNs by inspection and palpation immediately after surgery. Subsequently, fat dissolution liquid was applied to the remnant fat and the LN search was repeated. The primary endpoint was whether the second assessment would increase the number of evaluated LNs. Recruitment of 20 patients was planned. The study was conducted after institutional review board approval and written informed consent was obtained. Among 20 participants, 1 patient was excluded because LN dissection was not performed. The median number of LNs identified at the first and second assessments was 13 and 6, respectively, producing a significant increase in total LNs evaluated (13 vs. 20, respectively; P<0.01; paired t-test). One positive node was identified among the additionally identified LNs (0.9%, 1/107). The second assessment increased the number of LNs assessed to >12 in 4 patients, and although staging was not changed, the treatment was potentially altered in 2 stage II patients. The maximum diameter of the additionally obtained LNs was significantly smaller compared with those from the first assessment (4 vs. 7.7 mm, respectively; P<0.01; Wilcoxon signed-rank test). After the fat dissolution technique, the tumor cells were satisfactorily stained by carcinoembryonic antigen and cytokeratin-20. In conclusion, applying fat dissolution liquid to the remnant adipose tissue of the mesentery of the colon and rectum identified additional LNs. This method should be considered when insufficient LNs are identified after conventional LN retrieval.

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The impact of visceral adipose tissue amount on the adequacy of lymph node retrieval in colorectal cancer surgery

Choe

Park

Ryoo

et al. 2017

Journal of Surgical Oncology

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Does obesity impact lymph node retrieval in colon cancer surgery?

Cited by 41 publications

References 11 publications

Does Body Mass Index Affect the Number of Excised Lymph Nodes in Colorectal Cancer Surgery?

Does Body Mass Index Affect the Number of Excised Lymph Nodes in Colorectal Cancer Surgery?

Lymph node retrieval after dissolution of surrounding adipose tissue for pathological examination of colorectal cancer

The impact of visceral adipose tissue amount on the adequacy of lymph node retrieval in colorectal cancer surgery

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