title: Lymph node size as a simple prognostic factor in node negative colon cancer and an alternative thesis to stage migration.
abstract: BACKGROUND
  Stage migration is an accepted explanation for the association between lymph node (LN) yield and outcome in colon cancer. To investigate whether the alternative thesis of immune response is more likely, we performed a retrospective study.
  
  
  METHODS
  We enrolled 239 cases of node negative cancers, which were categorized according to the number of LNs with diameters larger than 5 mm (LN5) into the groups LN5-very low (0 to 1 LN5), LN5-low (2 to 5 LN5), and LN5-high (≥6 LN5).
  
  
  RESULTS
  Significant differences were found in pT3/4 cancers with median survival times of 40, 57, and 71 months (P = .022) in the LN5-very low, LN5-low, and LN5-high groups, respectively. Multivariable analysis revealed that LN5 number and infiltration type were independent prognostic factors.
  
  
  CONCLUSIONS
  LN size is prognostic in node negative colon cancer. The correct explanation for outcome differences associated with LN harvest is probably the activation status of LNs.
authors: Institute of Pathology, Klinikum Augsburg, Augsburg, Germany. Electronic address: bruno.maerkl@klinikum-augsburg.de.
authors: Bruno
authors: B
authors: Märkl
authors: Institute of Pathology, Klinikum Augsburg, Augsburg, Germany.
authors: Tina
authors: T
authors: Schaller
authors: IV Medical Clinic, Klinikum Augsburg, Augsburg, Germany.
authors: Yuriy
authors: Y
authors: Kokot
authors: Institute of Pathology, Klinikum Augsburg, Augsburg, Germany.
authors: Katharina
authors: K
authors: Endhardt
authors: Institute of Pathology, Klinikum Augsburg, Augsburg, Germany.
authors: Hallie
authors: H
authors: Kretsinger
authors: II Medical Clinic, Klinikum Augsburg, Augsburg, Germany.
authors: Klaus
authors: K
authors: Hirschbühl
authors: Department of Visceral and Transplantation Surgery, Klinikum Augsburg, Augsburg, Germany.
authors: Georg
authors: G
authors: Aumann
authors: Clinical and Population Based Cancer Registry Augsburg, Klinikum Augsburg, Augsburg, Germany.
authors: Gerhard
authors: G
authors: Schenkirsch
mesh_terms: D000230:Adenocarcinoma / Q000401:mortality / Q000473:pathology; D000368:Aged; D003110:Colonic Neoplasms / Q000401:mortality* / Q000473:pathology*; D005260:Female; D006801:Humans; D008197:Lymph Node Excision; D008198:Lymph Nodes / Q000473:pathology*; D008297:Male; D015999:Multivariate Analysis; D009367:Neoplasm Staging; D011379:Prognosis; D012189:Retrospective Studies; D016019:Survival Analysis
keywords: Colon cancer; Immune response; Lymph node; Size; Stage migration