Influence of obesity on lymph node recovery from rectal resection specimens

Görög, Dénes; Nagy, Péter; Péter, Antal; Perner, F.

doi:10.1007/bf03033734

Cited by 82 publications

(30 citation statements)

References 16 publications

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“…11 Görög et al demonstrated that a most significant reduction in the mean number of lymph nodes was observed in obese patients and that this subset of patients presented the lowest rate of nodal metastases. 17 In this series, the same proportion of obese patients was observed in both groups.…”

Section: Discussionsupporting

confidence: 56%

Can Adequate Lymphadenectomy be Obtained by Laparoscopic Resection in Rectal Cancer? Results of a Case–Control Study in 200 Patients

Sara

Poncet

Voirin

et al. 2010

Journal of Gastrointestinal Surgery

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Section: Discussionsupporting

confidence: 56%

Can Adequate Lymphadenectomy be Obtained by Laparoscopic Resection in Rectal Cancer? Results of a Case–Control Study in 200 Patients

Sara

Poncet

Voirin

et al. 2010

Journal of Gastrointestinal Surgery

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“…It remains unknown why age and gender were related to the NLNR as shown not only in the present but also in other studies (2,3,10). Studies have reported that the NLNR is influenced also by inflammation (21), diverticulum (21) and obesity (19,23,24). In this manner, the NLNR is determined most prominently by the extent of surgery, but is influenced to some degree by other factors.…”

Section: Discussionmentioning

confidence: 57%

Number of Lymph Nodes Retrieved is an Important Determinant of Survival of Patients with Stage II and Stage III Colorectal Cancer

Kotake

Honjo²,

Sugihara³

et al. 2011

Japanese Journal of Clinical Oncology

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Objective: The number of lymph nodes retrieved is recognized to be a prognostic factor of Stage II colorectal cancer. However, the prognostic significance of the number of lymph nodes retrieved in Stage III colorectal cancer remains controversial. Methods: The relationship between the number of lymph nodes retrieved and clinical and pathological factors, and significance of the number of lymph nodes retrieved for prognosis of Stage II and III colorectal cancer were investigated. A total of 16 865 patients with T3/T4 colorectal cancer who had R0 resection were analysed. Results: The arithmetic mean of the number of lymph nodes retrieved of all cases was 20.0. The number of lymph nodes retrieved were varied according to several clinical and pathological variables with significant difference, and the greater difference was observed in scope of nodal dissection. Survival of Stages II and III was significantly associated with the number of lymph nodes retrieved. Five-year overall survival of the patients with 9 of the number of lymph nodes retrieved and those with .27 differed by 6.4% for Stage II colon cancer, 8.8% for Stage III colon cancer, 12.5% for Stage II rectal cancer and 10.6% for Stage III rectal cancer. With one increase in the number of lymph nodes retrieved, the mortality risk was decreased by 2.1% for Stage II and by 0.8% for Stage III, respectively. The cut-off point of the number of lymph nodes retrieved was not obtained. Conclusions: The number of lymph nodes retrieved was shown to be an important prognostic variable not only in Stage II but also in Stage III colorectal cancer, and it was most prominently determined by the scope of nodal dissection. A cut-off value for the number of lymph nodes retrieved was not found, and it is necessary to carry out appropriate nodal dissection and examine as many lymph nodes as possible.

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“…This neoadjuvant therapy has been shown to result in a significant decrease in both the size and number of LNs available for examination after resection [29,35] . In addition, older age and obesity may reduce the number of LNs retrieved [29,32,36] . Also, the number of LNs that can be retrieved may also depend on the immune response of a patient as the size and morphology of LNs are modified by immune responses [37,38] .…”

Section: Total Number Of Dissected Lymph Nodes and N Stagementioning

confidence: 99%

Impact of metastatic lymph node ratio in node-positive colorectal cancer

Noura

Ohue²,

Kano³

et al. 2010

WJGS

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Colorectal cancer (CRC) is one of the most common malignant diseases in the world. Presently, the most widely used staging system for CRC is the tumor nodes metastasis classification system, which classifies patients into prognostic groups according to the depth of the primary tumor, presence of regional lymph node (LN) metastases, and evidence of distant metastatic spread. The number of LNs with confirmed metastasis is related to the severity of the disease, but this number depends on the number of LNs retrieved, which varies depending on patient age, tumor grade, surgical extent, and tumor site. Numerous studies and a recent structured review have demonstrated associated improvements in the survival of CRC patients with increasing numbers of LNs retrieved for examination. Hence, the impact of lymph node ratio (LNR), defined as the number of metastatic LNs divided by the number of LNs retrieved, has been investigated in various malignancies, including CRC. In this editorial, we review the literature demonstrating the clinicopathological significance of LNR in CRC pati ents. Some reports have indicated the advantage of considering the LNR compared to the number of LNs retrieved and/or LN status. When the LNR is taken into consideration for survival analysis, the number of LNs retrieved and/or the LN status is not always found to be a prognostic factor. The cutoff points for LNRs were proposed in numerous studies. However, optimal thresholds for LNRs have not yet received consensus. It is still unclear whether the LNR has more prognostic validity than N stage. For all these reasons, the potential advantages of LNRs in the staging system should be investigated in large prospective data sets.

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Influence of obesity on lymph node recovery from rectal resection specimens

Cited by 82 publications

References 16 publications

Can Adequate Lymphadenectomy be Obtained by Laparoscopic Resection in Rectal Cancer? Results of a Case–Control Study in 200 Patients

Can Adequate Lymphadenectomy be Obtained by Laparoscopic Resection in Rectal Cancer? Results of a Case–Control Study in 200 Patients

Number of Lymph Nodes Retrieved is an Important Determinant of Survival of Patients with Stage II and Stage III Colorectal Cancer

Impact of metastatic lymph node ratio in node-positive colorectal cancer

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