Factors that influence lymph node retrieval in the surgical treatment of colorectal cancer: a comparison of the laparoscopic versus open approach

Yacoub, Michael; Swistak, Stephen; Chan, Samson; Chichester, Tiffany; Dawood, Steven; Berri, Richard N.; Hawasli, Abdelkader

doi:10.1016/j.amjsurg.2012.11.003

Cited by 8 publications

(5 citation statements)

References 13 publications

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“…In our multivariate analyses, female patients had no statistical benefit for a high LNY. Some authors showed a correlation with the female sex [57,58,61,64], whereas others did not obtain such results [46,63,[65][66][67]. In the present study, no difference was found in the laparotomic and laparoscopic approaches, which confirmed the results of Beccera and Lykke et al [56,57] According to our study, a right-sided tumor location was beneficial for a LNY ≥ 12 (OR 2.3), which was congruent with other studies [56,57,63,[68][69][70][71][72].…”

Section: Discussionsupporting

confidence: 91%

“…In our multivariate analyses, female patients had no statistical benefit for a high LNY. Some authors showed a correlation with the female sex [ 57 , 58 , 61 , 64 ], whereas others did not obtain such results [ 46 , 63 , 65 , 66 , 67 ]. In the present study, no difference was found in the laparotomic and laparoscopic approaches, which confirmed the results of Beccera and Lykke et al [ 56 , 57 ]…”

Section: Discussionmentioning

confidence: 99%

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Prognostic Value of Metastatic Lymph Node Ratio and Identification of Factors Influencing the Lymph Node Yield in Patients Undergoing Curative Colon Cancer Resection

Mroczkowski,

Kim,

Otto

et al. 2024

Cancers

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Due to the impact of nodal metastasis on colon cancer prognosis, adequate regional lymph node resection and accurate pathological evaluation are required. The ratio of metastatic to examined nodes may bring an additional prognostic value to the actual staging system. This study analyzes the identification of factors influencing a high lymph node yield and its impact on survival. The lymph node ratio was determined in patients with fewer than 12 or at least 12 evaluated nodes. The study included patients after radical colon cancer resection in UICC stages II and III. For the lymph node ratio (LNR) analysis, node-positive patients were divided into four categories: i.e., LNR 1 (<0.05), LNR 2 (≥0.05; <0.2), LNR 3 (≥0.2; <0.4), and LNR 4 (≥0.4), and classified into two groups: i.e., those with <12 and ≥12 evaluated nodes. The study was conducted on 7012 patients who met the set criteria and were included in the data analysis. The mean number of examined lymph nodes was 22.08 (SD 10.64, median 20). Among the study subjects, 94.5% had 12 or more nodes evaluated. These patients were more likely to be younger, women, with a lower ASA classification, pT3 and pN2 categories. Also, they had no risk factors and frequently had a right-sided tumor. In the multivariate analysis, a younger age, ASA classification of II and III, high pT and pN categories, absence of risk factors, and right-sided location remained independent predictors for a lymph node yield ≥12. The univariate survival analysis of the entire cohort demonstrated a better five-year overall survival (OS) in patients with at least 12 lymph nodes examined (68% vs. 63%, p = 0.027). The LNR groups showed a significant association with OS, reaching from 75.5% for LNR 1 to 33.1% for LNR 4 (p < 0.001) in the ≥12 cohort, and from 74.8% for LNR2 to 49.3% for LNR4 (p = 0.007) in the <12 cohort. This influence remained significant and independent in multivariate analyses. The hazard ratios ranged from 1.016 to 2.698 for patients with less than 12 nodes, and from 1.248 to 3.615 for those with at least 12 nodes. The LNR allowed for a more precise estimation of the OS compared with the pN classification system. The metastatic lymph node ratio is an independent predictor for survival and should be included in current staging and therapeutic decision-making processes.

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Section: Discussionsupporting

confidence: 91%

“…In our multivariate analyses, female patients had no statistical benefit for a high LNY. Some authors showed a correlation with the female sex [ 57 , 58 , 61 , 64 ], whereas others did not obtain such results [ 46 , 63 , 65 , 66 , 67 ]. In the present study, no difference was found in the laparotomic and laparoscopic approaches, which confirmed the results of Beccera and Lykke et al [ 56 , 57 ]…”

Section: Discussionmentioning

confidence: 99%

Prognostic Value of Metastatic Lymph Node Ratio and Identification of Factors Influencing the Lymph Node Yield in Patients Undergoing Curative Colon Cancer Resection

Mroczkowski,

Kim,

Otto

et al. 2024

Cancers

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“…The lymph node counts are really more associated with the surgeon and pathologist than on the approach. [ 13 ] Some studies have demonstrated that female gender is a significant independent predicting factor in decreasing lymph nodes involvement. Our study did not show that sex would significantly influence the total number of lymph nodes recovered or the number of involved lymph nodes.…”

Section: Discussionmentioning

confidence: 99%

A report of the frequency of colorectal carcinoma and involved lymph nodes in South-West Iran

Shahbazian

Nasuri

Hosseini

et al. 2016

Indian J Med Paediatr Oncol

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Context:The colorectal cancer (CRC) is the most common malignancy between men and women. CRC has considerable morbidity and mortality, with more than 1000,000 new cases and 500,000 annual deaths. Regional lymph nodes are most common sites of metastasis from colon cancer. Lymph node involvement is an essential factor in enabling the accurate evaluation of prognosis in CRC patients.Aims:In this study, we focused on the frequency of CRC and involved lymph nodes and adequacy of lymph node dissection in patients who referred to the Oncology and Radiotherapy Department of Golestan Hospital in Ahvaz City located in South-West Iran.Setting and Design:We conducted a retrospective study among patients receiving surgical treatment for CRC in the Department of Oncology and Radiotherapy of Golestan Hospital in Ahvaz City located in South-West Iran between 2001 and 2010.Methods and Materials:All patients who underwent resection for CRC by open or laparoscopic approaches were included in the study. Data were collected from patients’ medical records.Statistical Analysis Used:Statistical data were analyzed using SPSS 21.Results:A total of 585 cases with CRC aged from16 to 89 years with mean age of 53-year-old were studied. Average number of dissected nodes was 8 lymph nodes, and lymph nodes were not found in pathology specimen of 61 cases (10.4%). In 199 patients (34.01%), number of dissected lymph nodes was 12 or more and in 386 patients (65.98%), number of dissected lymph nodes was <12.Conclusion:This study revealed a large amount of patients that had been under over treatment with radiotherapy and the following inability. Lack of removal of sufficient tissue by the surgeon during surgery or an inadequate sample check by a pathologist might lead to an inability to correct staging of the disease as well as the inability to determine the treatment program of the patients and over treatment with radiotherapy and chemotherapy.

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“…Other variables such as age, sex, race, or body mass index did not affect the total number of lymph nodes. Lymphadenectomy can be successfully performed by laparoscopic techniques, no demographic factors influencing the outcome [46][47][48].…”

Section: Robotic Surgerymentioning

confidence: 99%

Role of Minimally Invasive Surgery in Colon Cancer

Todosi¹,

Gavrilescu²,

Scripcariu³

2014

Surgery

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Colon cancer is a major public health problem. The treatment of colon cancer is primarily surgical using open and minimally invasive techniques. Minimally invasive surgery approaches for colon cancer include single-port laparoscopy, natural orifice transluminal endoscopic surgery, and robotic-assisted laparoscopic surgery. The techniques are based on the same principles: complete mesocolic excision, high vascular ligation, and extended lymphadenectomy. Laparoscopic surgery is characterized by short hospital stay, reduced postoperative pain, and less need for painkillers. Laparoscopic resections are less expensive than open surgery, but with similar quality of life outcomes. Robotic surgery is an alternative to open and laparoscopic techniques. This type of surgery results in a lower conversion rate and a shorter learning curve than laparoscopic surgery. When comparing the clinical outcomes of laparoscopic surgery versus open surgery no difference in disease free survival and overall survival were found. This article shows the role of minimally invasive surgery in colon cancer, the clinical outcomes of laparoscopic and open colon being similar.

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Factors that influence lymph node retrieval in the surgical treatment of colorectal cancer: a comparison of the laparoscopic versus open approach

Cited by 8 publications

References 13 publications

Prognostic Value of Metastatic Lymph Node Ratio and Identification of Factors Influencing the Lymph Node Yield in Patients Undergoing Curative Colon Cancer Resection

Prognostic Value of Metastatic Lymph Node Ratio and Identification of Factors Influencing the Lymph Node Yield in Patients Undergoing Curative Colon Cancer Resection

A report of the frequency of colorectal carcinoma and involved lymph nodes in South-West Iran

Role of Minimally Invasive Surgery in Colon Cancer

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