Adequate lymph node recovery improves survival in colorectal cancer patients1. Issue 8 (16th April 2013)

• Record Type: Journal Article
• Authors: Onitilo, Adedayo A.; Stankowski, Rachel V.; Engel, Jessica M.; Doi, Suhail A.R.
• Is Part Of: Journal of surgical oncology. Volume 107:Issue 8(2013:Jun. 15)
• Page Start: 828
• Page End: 834
• Publication Date: 2013-04-16
• Subjects: Cancer -- Surgery -- Periodicals; Neoplasms -- Periodicals; 616
• DOI: 10.1002/jso.23332
• Languages: English
• ISSNs: 0022-4790

Abstract

<abstract abstract-type="main" xml:lang="en"> <title>Abstract</title> <sec id="abs1-1" sec-type="section"> <title>Introduction</title> <p>Current recommendations suggest recovery of 12 lymph nodes during surgical resection for colorectal cancer (CRC) for proper staging and prognostication. Adequate lymph node recovery has been associated with improved patient survival, with results inconsistent.</p> </sec> <sec id="abs1-2" sec-type="section"> <title>Methods</title> <p>We examined factors for association with adequate lymph node recovery and used findings to adjust survival analyses to clarify whether adequate lymph node examination is associated with CRC survival or associated with a subset of characteristics that biases lymph node recovery.</p> </sec> <sec id="abs1-3" sec-type="section"> <title>Results</title> <p>In 74% of subjects (1, 036/1, 397) an adequate number of lymph nodes was examined. A stepwise multivariate regression analysis showed procedure year, cancer stage, tumor size, and age at diagnosis were significantly associated with lymph node recovery. These and other factors associated with survival status were adjusted for in further analyses, revealing no difference in unadjusted overall survival by adequacy of lymph node recovery (HR = 0.90, 95% CI: 0.75–1.08, <italic>P</italic> = 0.239). However, in adjusted Cox proportional hazards analysis, adequate lymph node recovery was associated with reduced risk for death (HR = 0.71, 95% CI: 0.57–0.89, <italic>P</italic> = 0.002).</p> </sec> <sec id="abs1-4" sec-type="section"> <title>Conclusion</title> <p>The current recommendation for retrieval and examination of at least 12 lymph nodes is appropriate for proper treatment and prognostication in patients undergoing surgical resection for CRC. J. Surg. Oncol. 2013;107:828–834. © 2013 Wiley Periodicals, Inc.</p> </sec> </abstract>