The distribution of lymph node metastases in right-sided colon cancer

We reviewed the surgical results of 57 patients with right-sided colon carcinoma (RCC) with special reference to lymph node metastasis. In 45 cured patients, 25 showed no lymph node metastasis (n0), 19 showed a low or moderate degree of lymph node metastasis (n1, n2), and only one showed a high degree of lymph node metastasis (n3). As for the remaining 12 cases, the reasons that operation did not lead to a cure were liver or lung metastasis (66%), peritoneal spread (17%), or extensive lymph node metastasis (17%). Among these patients, only one may have died from insufficient lymph node dissection (R2 < n3). The presence of lymph node metastasis was predicted by the serum carcinoembryonic antigen level (> 3.0 ng/ml) and histologic type (other than well differentiated). These results indicate that complete removal of the group 1 and 2 nodes (R2 dissection) is a feasible operation for RCC.