Part of the manuscript was originally presented by the first author at the 36th Annual Scientific Meeting of the Royal College of Surgeons of Thailand, jointly held by the American College of Surgeons, July 14–17, 2011, Thailand
Impact of lymph node retrieval on surgical outcomes in colorectal cancers†
Article first published online: 21 NOV 2011
Copyright © 2011 Wiley Periodicals, Inc.
Journal of Surgical Oncology
Volume 106, Issue 3, pages 238–242, 1 September 2012
How to Cite
Kritsanasakul, A., Boonpipattanapong, T., Wanitsuwan, W., Phukaoloun, M., Prechawittayakul, P. and Sangkhathat, S. (2012), Impact of lymph node retrieval on surgical outcomes in colorectal cancers. J. Surg. Oncol., 106: 238–242. doi: 10.1002/jso.22156
- Issue published online: 6 AUG 2012
- Article first published online: 21 NOV 2011
- Manuscript Accepted: 31 OCT 2011
- Manuscript Received: 16 AUG 2011
- Faculty of Medicine, Prince of Songkla University
- colorectal cancers;
- lymph node metastasis;
- lymph node retrieval
Adequacy of lymph node sampling is fundamental to the accuracy of nodal status (N-status) assessment in colorectal cancers (CRCs). This study aimed to determine the minimum sampling number to achieve reliable prognosis and to look for any association between the positive lymph node ratio (LNR) and overall survival (OS). Pathological reports of 533 stages I–III CRC patients who underwent curative resection during the period from January 1998 to December 2007 were retrospectively reviewed with regard to the number of lymph nodes obtained for pathological diagnosis (nLN) and number of positive nodes.
The median nLN was 10 nodes and the mean number of positive nodes was 1.7 nodes. On the N-status attribution plot, the cut-off point where the converging curves turned parallel was at 12 nodes. This cut-off was supported by the significant difference in OS between cases with nLN ≥ 12 (5-year OS 73.0%) and those with nLN < 12 (5-year OS 62.7%), (P-value < 0.01). Multivariate analysis showed that both nLN-12 and LNR were independent factors predicting survival probability.
Our data emphasize the importance of lymph node harvesting during the surgical resection of CRCs. In addition, LNR is a strong independent factor associated with CRC survival. J. Surg. Oncol. 2012; 106:238–242. © 2011 Wiley Periodicals, Inc.