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Adequacy of lymph node harvest following colectomy for obstructed and nonobstructed colon cancer
Author(s) -
Azin Arash,
Hirpara Dhruvin H.,
Draginov Arman,
Khorasani Mohammadali,
Patel Sunil V.,
O'Brien Catherine,
Quereshy Fayez A.,
Chadi Sami A.
Publication year - 2021
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.26274
Subject(s) - medicine , colorectal cancer , lymph node , odds ratio , colectomy , confidence interval , lymph , retrospective cohort study , surgery , cancer , gastroenterology , pathology
Background Technical and clinical differences in resection of obstructed and non‐obstructed colon cancers may result in differences in lymph node retrieval. The objective of this study is to compare the lymph node harvest following resection of obstructed and nonobstructed colon cancer patients. Methods A retrospective analysis utilizing the 2014–2018 NSQIP colectomy targeted data set was conducted. One‐to‐one coarsened exact matching (CEM) was utilized between patients undergoing resection for obstructed and non‐obstructed colon cancer. The primary outcome was the adequacy of lymph node retrieval (LNR, ≥12 nodes). Results CEM resulted in 9412 patients. Patients with obstructed tumors were more likely to have inadequate LNR (13.3% vs 8.2%, p < .001) compared to those with nonobstructed tumors. Multivariate analysis demonstrated that patients with obstructing tumors had worse LNR compared to non‐obstructed tumors (odds ratio [OR]: 0.74, 95% confidence interval [CI]: 0.62–0.87; p < .005). Increased age (OR: 0.99, 95% CI: 0.098–0.99), presence of preoperative sepsis (OR: 0.70, 95% CI: 0.055–0.90), left‐sided and sigmoid tumors compared to right‐sided (OR: 0.64, 95% CI: 0.51–0.81; OR: 0.69, 95% CI: 0.58–0.82, respectively), and open surgical resection compared to an minimally invasive surgical approach were associated with inadequate LNR ( p < .05). Conclusion This study demonstrated that resection for obstructing colon cancer compared to non‐obstructed colon cancer is associated with increased odds of inadequate lymph node harvest.