title: Lymph node evaluation in stage IIA colorectal cancer and its impact on patient prognosis: a population-based study.
abstract: BACKGROUND
  The analysis of regional lymph nodes is particularly relevant in patients with stage II colorectal cancer, in whom the role of adjuvant chemotherapy remains unclear. The aim of this study was to assess the relationship between number of examined lymph nodes and survival in patients with stage IIA (pT3N0M0) colorectal cancer, and to determine the optimal number of lymph nodes that should be examined.
  
  
  METHODS
  The study group included all the surgically-treated colorectal cancer patients in stage IIA (n = 657) who were identified through the population-based Cancer Registry of the Province of Modena (Northern Italy), during the period 2002-2006.
  
  
  RESULTS
  The median number of harvested lymph nodes was 19 (range 1-68). Considering, as a reference point, patients with 12 or less lymph nodes, subjects with n ≥ 20 lymph nodes examined showed, in univariate analysis, a significantly higher cancer specific (p = 0.01) and relapse-free survival (p = 0.003). The results were confirmed by multivariate analysis (Cox model).
  
  
  CONCLUSIONS
  The result suggests that colorectal cancer patients in stage IIA with n ≥ 20 lymph nodes examined exhibit better survival when compared with subjects in whom fewer lymph nodes were examined. The number of 20 lymph nodes is the essential requirement for an oncologic resection of the large bowel.
authors.affiliation: Department of Oncology, Hematology and Respiratory Diseases, University of Modena and Reggio Emilia , Modena , Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Iachetta
authors.forename: Luca
authors.initials: L
authors.lastname: Reggiani Bonetti
authors.forename: Luigi
authors.initials: L
authors.lastname: Marcheselli
authors.forename: Carmela
authors.initials: C
authors.lastname: Di Gregorio
authors.forename: Claudia
authors.initials: C
authors.lastname: Cirilli
authors.forename: Simona
authors.initials: S
authors.lastname: Messinese
authors.forename: Gian L
authors.initials: GL
authors.lastname: Cervo
authors.forename: Raffaella
authors.initials: R
authors.lastname: Postiglione
authors.forename: Katia
authors.initials: K
authors.lastname: Di Emidio
authors.forename: Monica
authors.initials: M
authors.lastname: Pedroni
authors.forename: Ernesto
authors.initials: E
authors.lastname: Longinotti
authors.forename: Massimo
authors.initials: M
authors.lastname: Federico
authors.forename: Maurizio
authors.initials: M
authors.lastname: Ponz de Leon
mesh_terms: D000230:Adenocarcinoma / Q000453:epidemiology / Q000401:mortality / Q000473:pathology* / Q000628:therapy; D002288:Adenocarcinoma, Mucinous / Q000453:epidemiology / Q000401:mortality / Q000473:pathology* / Q000628:therapy; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015179:Colorectal Neoplasms / Q000453:epidemiology / Q000401:mortality / Q000473:pathology* / Q000628:therapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007558:Italy / Q000453:epidemiology; D008198:Lymph Nodes / Q000473:pathology* / Q000601:surgery; D008297:Male; D008875:Middle Aged; D060787:Neoplasm Grading; D009361:Neoplasm Invasiveness; D009364:Neoplasm Recurrence, Local / Q000453:epidemiology / Q000401:mortality / Q000473:pathology* / Q000628:therapy; D009367:Neoplasm Staging; D011379:Prognosis; D018570:Risk Assessment; D015996:Survival Rate