Assessment of Factors Influencing Lymph Node Count in Colorectal Cancer
Suleyman Altintas1, Mehmet Bayrak2
1Departmentof Pathology, Adana City Hospital, Adana, Turkey.
Objective:
To evaluate the factors that influence pericolorectal lymph node (LN) retrieval from colectomy specimens in colorectal in cancer staging.
Study Design:
Descriptive study Place and Duration of Study: Ortadogu Private Hospital Adana, Turkey, between January 2012 and March 2018.
Methodology:
The inclusion criteria was right hemi-colon, left hemi-colon and rectum carcinoma specimen, respectively. The exclusion criteria was total colectomies due to synchronous colorectal carcinomas and cancers developed on the basis of ulcerative colitis and familial polyposis coli. Age and gender of the patients, the length of the colectomy specimen, the location and size of the tumor-node-metastasis (TNM) stage, and the count of retrieved lymph nodes were evaluated.
Results:
Among the 145 patients in this study, the mean count of recovered and metastatic lymph nodes was 32.5 and 2.9, respectively. Sufficient lymph node assessment was done in 130 of the 145 patients. The number of lymph node yields was independently associated with depth of invasion, T-classification, tumor size, AJCC/UICC stage as well as right-sided tumor location. The count of harvested lymph nodes significantly decreased in patients who received preoperative therapy. Increased node counts were associated with increased overall survival (OS).
Conclusion:
Tumor site and size, length of the surgical specimen, T-classification, depth of invasion and AJCC/UICC stage are predictors for the lymph node numbers in colorectal cancer surgery. Retrieval of removed nodes and counting helps in staging and number of removed nodes, and affects survival.
