The risk of lymph node metastasis in patients with T2 colon cancer

Aim It is often safe to treat pT1 tumours with local resection due to the low risk of lymph node metastasis. The risk of lymph node metastasis in pT2 colon cancer is less well investigated. The recommendation for patients diagnosed with T2 colon cancer is a segmental resection including regional lym...

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Bibliographic Details
Published in:Colorectal disease 2023-05, Vol.25 (5), p.853-860
Main Authors: Hartwig, Morten F., Slumstrup, Lasse, Fiehn, Anne‐Marie Kanstrup, Gögenur, Ismail
Format: Article
Language:English
Subjects:
Colon cancer
Colonic Neoplasms - pathology
Colonic Neoplasms - surgery
Colorectal cancer
Humans
Lymph Node Excision - methods
lymph node metastasis
Lymph nodes
Lymph Nodes - pathology
Lymph Nodes - surgery
Lymphatic Metastasis - pathology
Lymphatic system
Meta-analysis
Metastases
Metastasis
Neoplasm Staging
Patients
Retrospective Studies
Risk Factors
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Summary:Aim It is often safe to treat pT1 tumours with local resection due to the low risk of lymph node metastasis. The risk of lymph node metastasis in pT2 colon cancer is less well investigated. The recommendation for patients diagnosed with T2 colon cancer is a segmental resection including regional lymph nodes. The aim of this work was to determine the risk of lymph node metastasis in pT2 colon cancer and identify the possible associated clinical and pathological risk factors for lymph node metastasis. Method PubMed and Embase were systematically searched for studies describing patients with T2 colon cancer and lymph node status after histopathological assessment. Lymph node metastasis and the effect of histological and clinical factors were included. Results Overall, 5489 studies were screened, and 10 studies consisting of a total of 91 460 patients were included in the review. The overall risk of lymph node metastasis was 19.3% (95% confidence interval 19.0%–19.5%). A meta‐analysis was not possible as very few studies described the clinical and pathological risk factors for lymph node metastasis. Conclusion The risk of lymph node metastasis in patients with pT2 colon cancers is higher than for pT1. The studies included patients operated on from 1985 to 2015 with variations in surgical procedure, pathological handling, and definition of lymph node metastasis. Further studies reporting risk factors for lymph node metastasis in pT2 colon cancer are warranted as more data are needed to determine if local resection for a subgroup of patients could be an alternative treatment modality.
ISSN:1462-8910
1463-1318
DOI:10.1111/codi.16485