More is better: Lymph node harvesting in colorectal cancer

We sought to determine if lymph node harvesting and survival for CRC were comparable between laparoscopic and open resections in a community hospital setting.

A retrospective chart review of patients at two community hospitals who underwent open or laparoscopic resection for CRC between January 2008 and September 2013 was performed.

Three hundred seventy-one patients had open and 110 had laparoscopic resections. There was no difference between open (17.85) and laparoscopic (18.91) approaches (p = 0.171) in the number of lymph nodes harvested. Patients who had more nodes removed tended toward improved survival, independent of stage (p = 0.052), an effect that was more pronounced in the open resection group (p = 0.031). There was no difference in survival between the open and laparoscopic groups overall (HR 1.52, p = 0.208).

No survival advantage was found between the open and laparoscopic resection groups, affirming that the choice of operative approach for CRC does not affect the quality of the oncologic procedure in a community hospital setting. Patients who had more lymph nodes removed tended toward improved survival. The explanation for this effect remains unclear.