The impact of lymph node examination on survival of stage II colorectal cancer patients: Are 12 nodes adequate?

SummaryObjectiveEarly-stage colorectal cancer without lymph node (LN) metastasis is a disease requiring only surgery, except when it has a high risk. However, inadequate resection or LN examination is often followed by poor prognosis. In this study, we evaluated the adequacy of the number of LNs examined with regard to the survival of patients with stage II colorectal adenocarcinoma.MethodsBetween January 2003 and December 2006, patients with stage II colorectal cancer were enrolled in this study. Disease progression, background data, including tumor characteristics, and pathologic factors with an emphasis on the number of LNs examined and nodal status of the number of nodes variously involved were analyzed and correlated with survival.ResultsA total of 190 patients were included in our study. Using the receiver-operating characteristic curve and multivariate Cox proportional hazard regression analysis, we found that better overall survival was significantly associated with examination of >15 LNs (HR = 0.15, p = 0.001) and T3 stage (HR = 3.393, p = 0.024).ConclusionsIn this study, patients with stage II colorectal adenocarcinoma who had >15 LNs examined and were stage T3 had a better prognosis. In other words, we believe that examination of 12 LNs is not a sufficient number for evaluation of overall survival of such patients. We should follow-up patients with fewer examined LNs more closely.