Lymph Nodal Yield and Pattern of Spread in Carcinoma Rectum: A Study on Non-formalin Fixed Freshly Resected Surgical...

In colorectal malignancies that are locoregionally contained, lymph nodal yield and positivity are important prognostic factors. Nodal yield is affected by numerous factors including surgical and histopathological practice. We conducted a single-centre study including all patients who underwent curative surgery for adenocarcinoma of the rectum at our hospital. Specimens were collected in the operating room immediately following surgery for rectal cancer and evaluated before immersing in formalin. Dissection was done in the freshly resected specimen, in presence of a pathologist to retrieve lymph nodes. A total of 38 patients were included in the study. A total of 20 (52.63%) cases had positive nodes. The average lymph nodal yield was 20.68 ± 11.77. Factors that significantly affected the nodal harvest were tumour size, distance from the anal verge, radiological T stage, pathological N stage and neoadjuvant therapy. A maximum number of positive lymph nodes were found within 5 cm proximal to the tumour site, followed by nodes at the site of tumour, and nodes within 2.5 cm distal to the tumour site. The lymph nodal yield from non-formalin fixed freshly resected colorectal cancer specimens is high when done by the operating surgeon in the operating room. Several tumour and clinical factors affect the lymph nodal harvest.