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Impact of lymph node retrieval and pathological ultra‐staging on the prognosis of stage II colon cancer
Author(s) -
Law Calvin H.L.,
Wright Frances C.,
Rapanos Theodore,
Alzahrani Mohamed,
Hanna Sherif S.,
Khalifa Mahmoud,
Smith Andrew J.
Publication year - 2003
Publication title -
journal of surgical oncology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.201
H-Index - 111
eISSN - 1096-9098
pISSN - 0022-4790
DOI - 10.1002/jso.10309
Subject(s) - medicine , lymph , stage (stratigraphy) , lymphovascular invasion , colorectal cancer , lymph node , pathological , cancer , oncology , micrometastasis , retrospective cohort study , cancer staging , survival analysis , gastroenterology , surgery , metastasis , pathology , paleontology , biology
Background and Objectives A minimum number of lymph nodes must be assessed for accurate diagnosis of stage II colon cancer. We assessed number of lymph nodes retrieved, pathological ultra‐staging, and outcome in stage II colon cancer. Materials and Methods Consecutively treated patients with stage II colon cancer were identified. Baseline and outcome data were collected. Retrospective ultra‐staging using lymphovascular invasion (LVI) and nodal micrometastases was performed. Patients were divided into two groups: group I had ≤6 nodes and group II had >6 nodes retrieved. Survival was analyzed. Results One hundred and fifteen patients were included in the study. The 5 year overall survival was worse in group I versus II ( P = 0.03). LVI and micrometastases were identified but neither predicted survival. Disease failure in group I was due to distant metastases rather than local recurrence. Conclusions Inadequate retrieval and assessment of lymph nodes is associated with worse outcome in stage II colon cancer patients. Recurrence patterns support the hypothesis that disease recurrence occurred due to inaccurate staging. In this small study, LVI or nodal micrometastases did not predict survival. Maximal attention should be paid to the total number of lymph nodes retrieved before embarking on potentially more resource intensive staging methods. J. Surg. Oncol. 2003;84:120–126. © 2003 Wiley‐Liss, Inc.