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Factors influencing lymph node harvest in colorectal surgery

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International Journal of Colorectal Disease Aims and scope Submit manuscript

Abstract

Background and aims

Lymphadenectomy in colorectal cancer is a critical component concerning prognosis and survival of patients. Several variables influence the number of harvested lymph nodes (LN). However, results of studies are contradictory, and influencing factors remain to be identified. The aim of the present study was to identify factors that have a significant influence on the number of assessed LN in oncologic colorectal cancer resection.

Materials and methods

Three hundred and forty-one patients (190 men and 151 women), who underwent a colorectal cancer resection in a curative intention in the years 2000–2005, were analysed retrospectively. All specimens were histologically examined by two pathologists.

Results

In a median, 15.1 LN per operation were resected. Early tumour stage (p < 0.01), length of resected bowel segment (p < 0.05) and right-sided location (p < 0.001) had a significant influence on the number of resected LN. Age, gender, surgeon volume, differentiation of the tumour, LN metastases, lymphatic invasion and depth of tumour invasion had no significant association with harvested LN number. Furthermore, the presence or absence of the vermiform appendix and the length of the resected ileum segment in right-sided resections did not significantly affect the assessed LN.

Conclusion

The question arises whether for colorectal cancers of all locations the same amount of resected and analysed LNs should be lasting to fulfill oncologic criteria, as the number of harvested LNs depends on several parameters.

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Author information

Authors and Affiliations

  1. Department of General and Visceral Surgery, Augusta-Kranken-Anstalt, Bergstrasse 26, 44791, Bochum, Germany

    M. Gelos, P. Mehnert, G. Bonhag, M. Sand & B. Mann

  2. Department of Urology, Bundeswehrkrankenhaus, Berlin, Germany

    J. Gelhaus

  3. Department of Pathology, Augusta-Kranken-Anstalt, Bochum, Germany

    S. Philippou

Authors
  1. M. Gelos
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  2. J. Gelhaus
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  3. P. Mehnert
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  4. G. Bonhag
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  5. M. Sand
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  6. S. Philippou
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  7. B. Mann
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Corresponding author

Correspondence to M. Gelos.

Appendices

Appendix A

A.1 Tables

Table 1 Association between age, gender and histopathological variables (N, G, L) on lymph node harvest
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Table 2 Association between lymph node harvest and lymph node metastases
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Table 3 Association between individual surgeon and lymph node harvest
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Table 4 Association between presence of vermiform appendix and lymph node harvest
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Appendix B

B.1 Figure legends

Fig. 1
figure 1

Association of depth of tumour invasion and lymph node harvest. Lymph node harvest depends on depth of tumour invasion. Specimens of T1 tumours significantly yield less lymph nodes compared to the other tumour stages. Asterisk, p < 0.01

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Fig. 2
figure 2

Lymph node harvest depends on type of resection. Significant association between type of resection and lymph node harvest. LN Lymph node number; asterisk: compared to the other types of resections, the yielded lymph node number is significantly higher (p < 0.001)

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Fig. 3
figure 3

Number of resected lymph nodes depends on length of bowel segment. Significant association between length of bowel segment and number of harvested lymph nodes (p < 0.01)

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Gelos, M., Gelhaus, J., Mehnert, P. et al. Factors influencing lymph node harvest in colorectal surgery. Int J Colorectal Dis 23, 53–59 (2008). https://doi.org/10.1007/s00384-007-0378-8

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  • DOI: https://doi.org/10.1007/s00384-007-0378-8

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