Factors influencing lymph node harvest in colorectal surgery.
OBJECTIVE
Lymphadenectomy in colorectal cancer is a critical component concerning prognosis and survival of patients. Several variables influence the number of harvested lymph nodes (LN). However, results of studies are contradictory, and influencing factors remain to be identified. The aim of the present study was to identify factors that have a significant influence on the number of assessed LN in oncologic colorectal cancer resection.


METHODS
Three hundred and forty-one patients (190 men and 151 women), who underwent a colorectal cancer resection in a curative intention in the years 2000-2005, were analysed retrospectively. All specimens were histologically examined by two pathologists.


RESULTS
In a median, 15.1 LN per operation were resected. Early tumour stage (p<0.01), length of resected bowel segment (p<0.05) and right-sided location (p<0.001) had a significant influence on the number of resected LN. Age, gender, surgeon volume, differentiation of the tumour, LN metastases, lymphatic invasion and depth of tumour invasion had no significant association with harvested LN number. Furthermore, the presence or absence of the vermiform appendix and the length of the resected ileum segment in right-sided resections did not significantly affect the assessed LN.


CONCLUSIONS
The question arises whether for colorectal cancers of all locations the same amount of resected and analysed LNs should be lasting to fulfill oncologic criteria, as the number of harvested LNs depends on several parameters.
Gelos
M
M
Department of General and Visceral Surgery, Augusta-Kranken-Anstalt, Bergstrasse 26, 44791 Bochum, Germany. gelos@augusta-bochum.de
Gelhaus
J
J
Mehnert
P
P
Bonhag
G
G
Sand
M
M
Philippou
S
S
Mann
B
B
D000368:Aged; D003082:Colectomy; D015179:Colorectal Neoplasms / Q000473:pathology / Q000601:surgery*; D005260:Female; D006801:Humans; D008197:Lymph Node Excision; D008207:Lymphatic Metastasis; D008297:Male; D009361:Neoplasm Invasiveness; D009367:Neoplasm Staging; D012189:Retrospective Studies; D016896:Treatment Outcome