Insufficient Lymph Node Dissection Is an Independent Risk Factor for Postoperative Cancer Death in Patients Undergoing Surgery for Stage II Colorectal Cancer

Abstract

Background: Surgical resection is the most effective treatment for patients with stage II colorectal cancer (CRC). However, a few patients with early-phase CRC suffer postoperative cancer death. Aims: To investigate the risk factors for postoperative cancer death in patients who undergo surgery for stage II CRC. Methods: Prognostic significance was analyzed by χ² test, univariate analyses, Kaplan-Meier analysis and log-rank test using clinicopathological factors from the database. Results: A total of 205 patients with stage II CRC were evaluated. Age (≤65/>65 years), venous invasion (negative/positive), number of dissected lymph nodes (≤9/≧10), grade of lymph node dissection (sufficient/insufficient) and albumin level (<3.5/≧3.5 g/dl) were associated with shorter overall survival. Univariate analysis of the clinicopathological factors revealed that only the grade of lymph node dissection (sufficient/insufficient) was associated with postoperative cancer death (odds ratio 2.993, 95% confidence interval 1.216–7.368, p = 0.017).Kaplan-Meier analysis and log-rank test revealed that the group with insufficient lymph node dissection had a higher incidence of postoperative cancer death than the group with sufficient dissection (p < 0.001). Conclusions: Insufficient lymph node dissection is an independent risk factor for postoperative cancer death in patients who undergo surgery for stage II CRC.

Effect of activated carbon nanoparticles on lymph node harvest in patients with colorectal cancer

“…As mentioned earlier, inadequate lymph node assessment can lead to understaging of patients and thus delay life‐saving adjuvant treatment. Multiple reports have shown that inadequate lymph node evaluation is correlated with shorter overall survival in CRC patients with or without metastatic lymph nodes . In particular, the small lymph nodes omitted during surgery might be metastatic.…”

Adequate lymph node recovery improves survival in colorectal cancer patients

“…Many studies have demonstrated that insufficient lymph node examination is associated with shorter overall survival in both node‐negative and node‐positive CRC patients 7–13. In 2007, Chang et al 27 published a comprehensive systematic review of 17 studies that examined lymph node recovery as it relates to CRC survival.…”

“…Many studies have demonstrated that insufficient lymph node examination is associated with shorter overall survival in both node‐negative and node‐positive CRC patients 7–13. The National Comprehensive Cancer Network, American Joint Committee on Cancer, and American College of Pathologists recommend the examination of at least 12 lymph nodes for adequate CRC staging 3, 14, 15.…”

The Prognostic Ability of Log Odds of Positive Lymph Nodes in Oral Cavity Squamous Cell Carcinoma

“…The prognostic ability of pN may be influenced by the total number of lymph nodes removed and the pN classification requires a minimal number of retrieved nodes in order to prevent stage migration. 5 – 7 The ratio-based system (rN), representing the ratio of positive nodes to total retrieved nodes, has been proven to better predict outcomes than pN. 6 , 8 – 10 Our previous study validated the utility of rN utility in such major cancers as breast cancer, colorectal cancer, and HNC in Taiwan.…”