Factors influencing lymph node skip metastasis in colorectal cancer: a retrospective study

Background The risk factors for lymph node skip metastasis ( LNSM ) have not been thoroughly clarified in patients with advanced colorectal cancer ( CRC ). This study aimed to identify the risk factors for LNSM in CRC patients who underwent laparoscopic radical resection with D3 lymphadenectomy. Methods This retrospective cohort study included a total of 167 consecutive patients who underwent laparoscopic radical resection with D3 lymphadenectomy for CRC between April 2005 and June 2017. The patients were sorted into the LNSM ‐positive (skip+ group) and LNSM ‐negative (skip− group) groups. Logistic regression was used to identify the risk factors for LNSM . Results Compared with the skip− group, the frequency of tumour size <5 cm, pT1 ‐2 stage, and pN1 stage were significantly higher in the skip+ group (tumour size <5 cm: 68.8 versus 46.7%, P = 0.025; pT1 ‐2 stage: 18.8 versus 4.4%, P = 0.012; pN1 stage: 78.1 versus 57.0%, P = 0.028), respectively. Multivariate logistic regression analysis revealed that pT1 ‐2 stage (odds ratio ( OR ) = 4.3, 95% confidence interval ( CI ): 1.1–16.6, P = 0.034) and pN1 stage ( OR = 2.6, 95% CI : 1.1–6.8, P = 0.047) were independent risk factors for LNSM . Conclusions pT1 ‐2 stage and pN1 stage are significantly associated with LNSM . Radical D3 lymphadenectomy should remain standard practice for CRC .