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Background  To identify factors affecting the harvest of lymph nodes (LNs) and to investigate the association between examining a minimum of 12 LNs and clinical outcomes in stage I-III colorectal cancer (CRC) patients.    Methods  The clinicopathologic features and the number of examined LNs for 1167 stage I-III CRC patients were analyzed to identify factors affecting the number of LNs harvested and the correlations between clinical outcomes and high harvests (≧12 LNs) and low harvests (<12 LNs).    Results  A multivariate analysis showed that age ( P  = 0.007), tumor size ( P  = 0.030), and higher T stage ( P  = 0.001) were independent factors affecting the examinations of LNs in colon cancer and that tumor size ( P  = 0.015) was the only independent factor in rectal cancer. Patients with low harvests had poorer overall survival with stage II and stage III CRC (stage II:  P  < 0.0001; III:  P  = 0.001) and poorer disease-free survival for stages I-III (stage I:  P  = 0.023; II:  P  < 0.0001; III:  P  = 0.001).    Conclusions  The factors influencing nodal harvest are multifactorial, and an adequate number of examined LNs (≧12) is associated with a survival benefit. Removal of at least 12 LNs will determine the lymph node status reliably.

bmc surgery

Factors affecting number of lymph nodes harvested and the impact of examining a minimum of 12 lymph nodes in stage I-III colorectal cancer patients: a retrospective single institution cohort study of 1167 consecutive patients