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Adequate Lymph Node Recovery Improves Survival in Colorectal Cancer Patients

Date

2013

Authors

Onitilo, Adedayo A.
Stankowski, Rachel V.
Engel, Jessica M.
Doi, Suhail

Journal Title

Journal ISSN

Volume Title

Publisher

American Scientific Publishers

Abstract

Introduction Current recommendations suggest recovery of 12 lymph nodes during surgical resection for colorectal cancer (CRC) for proper staging and prognostication. Adequate lymph node recovery has been associated with improved patient survival, with results inconsistent. Methods We examined factors for association with adequate lymph node recovery and used findings to adjust survival analyses to clarify whether adequate lymph node examination is associated with CRC survival or associated with a subset of characteristics that biases lymph node recovery. Results In 74% of subjects (1,036/1,397) an adequate number of lymph nodes was examined. A stepwise multivariate regression analysis showed procedure year, cancer stage, tumor size, and age at diagnosis were significantly associated with lymph node recovery. These and other factors associated with survival status were adjusted for in further analyses, revealing no difference in unadjusted overall survival by adequacy of lymph node recovery (HR = 0.90, 95% CI: 0.75-1.08, P = 0.239). However, in adjusted Cox proportional hazards analysis, adequate lymph node recovery was associated with reduced risk for death (HR = 0.71, 95% CI: 0.57-0.89, P = 0.002). Conclusion The current recommendation for retrieval and examination of at least 12 lymph nodes is appropriate for proper treatment and prognostication in patients undergoing surgical resection for CRC.

Description

Keywords

Keywords: article; cancer staging; cancer surgery; cancer survival; colorectal cancer; female; groups by age; human; lymph node; major clinical study; male; mortality; outcome assessment; overall survival; priority journal; retrospective study; risk reduction; surv colorectal cancer; lymph node recovery; staging; survival

Citation

Source

Journal of Surgical Oncology

Type

Journal article

Book Title

Entity type

Access Statement

License Rights

DOI

10.1002/jso.23332

Restricted until

2037-12-31