Korean J Clin Oncol.  2022 Jun;18(1):27-35. 10.14216/kjco.22004.

Is a cutoff value of 12 still useful in stage II right-sided colon cancer without risk factors?

• Hwang J
• Lee D
• Shin JK
• Jang JH
• Huh JW
• Park YA
• Cho YB
• Kim HC
• Yun SH
• Lee WY
• Chun HK

• KMID: 2531834
• DOI: http://doi.org/10.14216/kjco.22004

Abstract

Purpose
Various clinical practice guidelines recommend at least 12 regional lymph nodes should be removed for resected colon cancer. According to a recent study, the lymph node yield (LNY) in colon cancer surgery in the last 20 years has tended to increase from 14.91 to 21.30. However, it is unclear whether these guidelines adequately reflect recent findings on the number of harvested lymph nodes in colon cancer surgery. The aim of this study is to assess the impact of an LNY of more than 25 on survival in right-sided colon cancer.
Methods
We included 285 patients who underwent a right hemicolectomy during the period from January 2010 through December 2015. Patients were divided into two groups (<25 nodes and ≥25 nodes). Primary endpoints included 5-year and 10-year survival including disease-free and overall.
Results
We found that survival outcomes of patients with a harvest of ≥25 nodes were not significantly different compared with a <25 group. Large tumor size (5 cm) is significantly associated with poor 5-year and 10-year overall survival.
Conclusion
Survival outcomes of patients with a harvest of ≥25 nodes were not significantly different compared with the <25 group in stage II colon cancer with no risk.

Keyword

Colonic neoplasms; Lymph node yield; Cutoff value; Prognosis; Survival