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International Journal of Colorectal Disease

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Open Access 01-07-2017 | Original Article

Lymph node retrieval in colorectal cancer: determining factors and prognostic significance

Authors: Johannes Betge, Lars Harbaum, Marion J. Pollheimer, Richard A. Lindtner, Peter Kornprat, Matthias P. Ebert, Cord Langner

Published in: International Journal of Colorectal Disease | Issue 7/2017

Abstract

Purpose

The study aimed to analyze clinicopathological factors that determine the extent of lymph node retrieval and to evaluate its prognostic impact in patients with colorectal cancer (CRC).

Methods

The number of retrieved lymph nodes was analyzed in 381 CRC specimens. Lymph node count was related to different clinicopathological variables by binary logistic regression. Progression-free survival (PFS) and cancer-specific survival (CSS) were determined using the Kaplan-Meier method and Cox regression models.

Results

The median number of retrieved lymph nodes was 20 (mean 21 ± 10, range 1–65) in right-sided, 13 (16 ± 10, 1–66) in left-sided, and 15 (18 ± 11, 3–64) in rectal tumors. The number of retrieved lymph nodes was independently associated with T-classification (p < 0.001), N-classification (p = 0.014), and tumor size (p = 0.005) as well as right-sided tumor location (p = 0.012). There was no association with age, sex, tumor grade, mismatch-repair status, and lymph or blood vessel invasion. The longer the surgical specimen, the higher were the numbers of retrieved and positive lymph nodes (p < 0.001, respectively). In patients with locally advanced (T3/T4) tumors (n = 283), analysis of more than 12 lymph nodes was independently associated with PFS (HR = 0.63, p = 0.025) and CSS (HR = 0.54, p = 0.004). In the subset of T3/T4 N0 patients (n = 130), analysis of more than 12 lymph nodes similarly proved to be an independent predictor of outcome (PFS, HR = 0.48, p = 0.046; OS, HR = 0.41, p = 0.026).

Conclusion

The number of retrieved lymph nodes is associated with higher tumor stage, tumor size, and right-sided location. Low lymph node count indicates adverse outcome in patients with locally advanced (T3/T4) disease.

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Title: Lymph node retrieval in colorectal cancer: determining factors and prognostic significance
Authors: Johannes Betge
Lars Harbaum
Marion J. Pollheimer
Richard A. Lindtner
Peter Kornprat
Matthias P. Ebert
Cord Langner
Publication date: 01-07-2017
Publisher: Springer Berlin Heidelberg
Published in: International Journal of Colorectal Disease / Issue 7/2017
Print ISSN: 0179-1958
Electronic ISSN: 1432-1262
DOI: https://doi.org/10.1007/s00384-017-2778-8

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Lymph node retrieval in colorectal cancer: determining factors and prognostic significance

Abstract

Purpose

Methods

Results

Conclusion

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