Number of retrieved lymph nodes and survival in node-negative patients undergoing laparoscopic colorectal surgery for cancer

Nir, Smadar; Greenberg, Ron; Shacham‐Shmueli, Einat; White, Ian; Schneebaum, Schlomo; Avital, Shmuel

doi:10.1007/s10151-010-0578-z

Cited by 10 publications

(1 citation statement)

References 19 publications

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“…Nevertheless, this “stage migration” hypothesis has been proposed to be at least partially responsible for improvements in outcome measures associated with procedures employing more aggressive lymphadenectomy strategies. Inevitably, however, some authors suggest that the stage migration hypothesis may be less relevant than initially thought [42, 81–83], with up‐staging not necessarily influencing disease‐free survival [84]. A further complicating variable is that low‐volume hospitals may tend to under‐stage tumors pathologically [85], with the potential for staging inaccuracies to adversely affect reported clinical outcome measures following extended lymph node resection in both an uncontrolled and unquantifiable fashion.…”

Section: Role Of Lymphadenectomy In Stage Migrationmentioning

confidence: 99%

Extended Lymphadenectomy in Colon Cancer Is Debatable

Murphy

Young‐Fadok

2013

World j. surg.

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Extended lymphadenectomy has gained considerable attention as an adjunct to conventional colon cancer surgery with the hope that it may potentially decrease local recurrence rates and improve cancer-specific outcome measures. Despite the enthusiasm surrounding these techniques, it is difficult to establish any additional survival benefit associated with more comprehensive lymphadenectomy strategies when these are performed in addition to conventional colon cancer surgery. Furthermore, these techniques remain unproven by large randomized clinical trials. The appropriate indications for performing extended lymphadenectomy also remain unclear, and there is a lack of standardization with regard to surgical technique. Moreover, there are a number of confounding factors that frequently receive little attention when oncological outcome measures are reported following extended lymphadenectomy in the setting of colon cancer. The purpose of this review is to outline these confounding issues and discuss their impact on reports describing cancer-specific outcome measures following the use of extended lymphadenectomy techniques. Furthermore, this review proposes that in light of the available published evidence, the role of radical lymphadenectomy is currently unproven, with large randomized clinical trials required in the future to determine whether there is a survival benefit for colon cancer patients.

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