, Volume 24, Issue 11, pp 2921-2923
Date: 31 Mar 2010

Laparoscopic colorectal cancer resection: examining lymph nodes or standardizing surgery?

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There is now debate about how many lymph nodes should be dissected during colorectal cancer (CRC) by surgery and subsequently retrieved from the specimen and examined by pathologists. Appropriate lymphadenectomy is crucial for the patient’s oncological outcome for two reasons. First, it reduces the risk of residual nodal disease, and second, examination of only a large number of lymph nodes allows for accurate nodal staging. The pathological tumor-node-metastasis (pTNM) staging by examining a sufficient number of lymph nodes allows an accurate estimation of the ratio between positive and total number of lymph nodes evaluated. This global nodal status information is necessary for making a decision about adjuvant systemic chemotherapy.

Recent guidelines from scientific associations and organizations, including the American College of Surgeons (ACS), the National Quality Forum (NQF), the National Comprehensive Cancer Network (NCCN), and the American Society for Clinical Oncology (ASCO), re