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Updated: May 18, 2026
Robot-assisted Total Mesorectal Excision and Lateral Pelvic Lymph Node Dissection for Locally Advanced Middle-low Rectal Cancer
Published on: February 12, 2022
Should quality measures for lymph node dissection in colon cancer be extrapolated to rectal cancer?
Travis B Kidner1, Junko J Ozao-Choy, Jeong Yoon
1Department of Surgical Oncology, John Wayne Cancer Institute at Saint John's Health Center, Santa Monica, CA, USA. kidnert@jwci.org
Background:
A minimum of 12 lymph nodes has been endorsed as a quality measure to confirm node-negative colon cancer, but its relevance to early-stage rectal cancer is unclear.
Methods:
Patients with stage I or II rectal cancer from the Surveillance, Epidemiology and End Results tumor registries from 1998 to 2002 were identified. Patients were grouped by the number of lymph nodes sampled. Groups were compared for patient demographics, tumor characteristics, and 5-year overall survival.
Results:
Of the 6,214 patients (57% men) identified, only 33% had ≥12 lymph nodes examined in the surgical specimen. Multivariate analysis identified sex, race, age, T stage, and number of lymph nodes examined as independent predictors of 5-year overall survival.
Conclusions:
Five-year overall survival improved as the number of sampled nodes increased. A thorough lymphadenectomy should routinely be performed to optimize staging and to improve survival of patients with early-stage rectal cancer.
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