title: The relationship of lymph node dissection and colon cancer survival in the Veterans Affairs Central Cancer Registry.
abstract: BACKGROUND
  The extent of lymphadenectomy in colon cancer may impact potential to cure and accuracy of staging.
  
  
  METHODS
  The Veterans Affairs Central Cancer Registry database was queried for TNM stage I-III colon adenocarcinoma patients and yielded 5,823 individuals. The number of lymph nodes examined, number positive, and the positive:examined lymph node ratio were studied with respect to overall survival by using log-rank and Kaplan-Meier analysis.
  
  
  RESULTS
  The overall survival (OS) in stage II patients was greater with the higher number of lymph node (LN) examined. For stage II patients, the 5-year OS was 34%, 43%, 47%, and 55% for the lowest to highest quartiles (P = .007). For stage III patients, the 5-year OS was 31%, 27%, 38%, and 53% for the lowest to highest quartiles (not significant overall). OS is greater with an increased number of positive lymph nodes (P < .001). The lymph node ratio was more powerful prognostically with a 5-year OS of 27% for the highest quartile versus 44% for the lowest.
  
  
  CONCLUSIONS
  More extensive lymphadenectomy is associated with improved OS in stage II colon cancer patients. The positive:examined LN ratio is more powerful prognostically than the number of nodes examined or LN positivity.
authors: Department of Surgery, Cincinnati VA Medical Center and University of Cincinnati, 231 Albert Sabin Way, ML#0558, Cincinnati, OH 45267, USA. joshuamammen@gmail.com
authors: Joshua M V
authors: JM
authors: Mammen
authors: Laura E
authors: LE
authors: James
authors: Mark
authors: M
authors: Molloy
authors: Arthur
authors: A
authors: Williams
authors: Curtis J
authors: CJ
authors: Wray
authors: Jeffrey J
authors: JJ
authors: Sussman
mesh_terms: D000230:Adenocarcinoma / Q000401:mortality* / Q000601:surgery*; D000368:Aged; D003110:Colonic Neoplasms / Q000401:mortality* / Q000601:surgery*; D005260:Female; D006801:Humans; D008197:Lymph Node Excision; D008297:Male; D012042:Registries; D015996:Survival Rate; D014481:United States; D014493:United States Department of Veterans Affairs