Number of retrieved lymph nodes and survival in node-negative patients undergoing laparoscopic colorectal surgery for cancer.
BACKGROUND
The number of retrieved lymph nodes in colorectal cancer resection may have an impact on staging and survival. Examination of at least 12 nodes has become a quality measure for adequate surgical practice. To evaluate the impact of the number of retrieved lymph nodes in laparoscopic colorectal surgery for cancer on node-negative patients' survival.


METHODS
Evaluation of our prospective in-hospital collected data of patients that underwent laparoscopic surgery for curable colorectal cancer over a 5-year period. Long-term data were collected from our outpatient's clinic data and personal contact when necessary.


RESULTS
During a 5-year period since September 2003,173 patients were operated laparoscopically for curable colorectal cancer. Of the 117 patients who were node negative, 85 node-negative patients (72%) had 12 or more evaluated lymph nodes (mean, 18.3 + 2.4), while 32 node-negative patients had less than 12 (mean, 8.3 + 6.2). Patients with fewer than 12 nodes evaluated had significantly more left-sided tumors, while patients with 12 nodes or more had more right-sided tumors. A comparison of 5-year disease free and overall Kaplan-Meier survival curves revealed no statistically significant difference between the two groups.


CONCLUSIONS
Evaluation of less than 12 nodes may not necessarily impact patients' survival in node-negative patients undergoing laparoscopic resection for curable colorectal cancer. A lower number of nodes may be sufficient.
Nir
S
S
Department of Surgery A, Tel-Aviv Medical Center, Tel-Aviv University, Tel-Aviv, Israel.
Greenberg
R
R
Shacham-Shmueli
E
E
White
I
I
Schneebaum
S
S
Avital
S
S
D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D003110:Colonic Neoplasms / Q000401:mortality / Q000473:pathology* / Q000601:surgery*; D005260:Female; D006801:Humans; D010535:Laparoscopy; D008197:Lymph Node Excision; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011237:Predictive Value of Tests; D012004:Rectal Neoplasms / Q000401:mortality / Q000473:pathology* / Q000601:surgery*; D012189:Retrospective Studies; D012307:Risk Factors; D015996:Survival Rate
Langenbecks Arch Surg. 2006 Aug;391(4):364-8
16683146
CA Cancer J Clin. 2009 Jul-Aug;59(4):225-49
19474385
J Natl Cancer Inst. 2005 Feb 2;97(3):219-25
15687365
Ann Surg Oncol. 2003 Jan-Feb;10(1):65-71
12513963
Dis Colon Rectum. 1999 Feb;42(2):143-54; discussion 154-8
10211489
JAMA. 2007 Nov 14;298(18):2149-54
18000198
Gastrointest Cancer Res. 2009 Mar;3(2 Suppl):S33-5
19461921
J Clin Oncol. 2007 Jul 20;25(21):3061-8
17634484
Eur J Cancer. 2005 Jan;41(2):272-9
15661553
J Natl Cancer Inst. 2007 Mar 21;99(6):433-41
17374833
Tech Coloproctol. 2009 Jun;13(2):113-21
19484349
Hepatogastroenterology. 2005 Nov-Dec;52(66):1703-6
16334761
Ann Surg. 2007 Oct;246(4):655-62; discussion 662-4
17893502
J Natl Cancer Inst. 2001 Apr 18;93(8):583-96
11309435
Surg Endosc. 2007 Dec;21(12):2142-6
17522917
J Natl Cancer Inst. 2008 Sep 17;100(18):1310-7
18780863
Dig Dis. 2007;25(1):67-75
17384510
Cancer. 1998 Aug 15;83(4):666-72
9708929
Arch Surg. 2009 Jul;144(7):612-7
19620539
Ann Surg. 2002 Apr;235(4):458-63
11923600
World J Surg. 2002 Mar;26(3):384-9
11865379