The Impact of the Ratio of Positive to Total Lymph Nodes Examined and Outcome in Colorectal Cancer

We sought to examine the significance of the number of nodes examined in node-positive colorectal cancer. Between January 1, 1994, and December 31, 2003, 7192 patients with colorectal cancer underwent potentially curative resection in Region 5 of the California Cancer Registry. Of these patients, 26...

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Bibliographic Details
Published in:The American surgeon 2009-10, Vol.75 (10), p.873-876
Main Authors: NG, Melody, ROY-CHOWDHURY, Sharmila, LUM, Sharon S, MORGAN, John W, WONG, Jan H
Format: Article
Language:English
Subjects:
Adolescent
Adult
Aged
Aged, 80 and over
Biological and medical sciences
Breast cancer
California
Cohort Studies
Colorectal cancer
Colorectal Neoplasms - mortality
Colorectal Neoplasms - pathology
Colorectal Neoplasms - surgery
Female
Gastroenterology. Liver. Pancreas. Abdomen
General aspects
Hematologic and hematopoietic diseases
Humans
Leukemias. Malignant lymphomas. Malignant reticulosis. Myelofibrosis
Lymph Node Excision
Lymph Nodes - pathology
Lymphatic Metastasis
Male
Medical sciences
Metastasis
Middle Aged
Neoplasm Staging
Ratios
Retrospective Studies
Review boards
SEER Program
Stomach. Duodenum. Small intestine. Colon. Rectum. Anus
Survival Rate
Tumors
Young Adult
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Summary:We sought to examine the significance of the number of nodes examined in node-positive colorectal cancer. Between January 1, 1994, and December 31, 2003, 7192 patients with colorectal cancer underwent potentially curative resection in Region 5 of the California Cancer Registry. Of these patients, 2636 patients were node-positive: 65.1 per cent were N1 and 34.9 per cent were N2. The median follow up was 39.5 months. The mean number of nodes examined was 10.4 (range, 1-89) for N0, 11.0 (range, 1-72) for N1, and 14.6 (range, 4-79) for N2 (P < 0.0001). N1 and N2 patients were stratified according to the percentage of positive nodes into quintiles (0.19 or less, 0.20 to 0.39, 0.40 to 0.59, 0.60 to 0.79, and 0.80 to 1.0). In both N1 and N2 disease, a lower percentage of lymph nodes involved with metastatic disease was associated with improved survival (P < 0.0001). The increasing ratio of positive to total nodes was the result of a decrease in the total number of nodes examined in N1 disease and a steeper decline in total nodes examined in relation to the increase in the number of positive nodes in N2 disease. The ratio of positive to total nodes has prognostic significance in node-positive colorectal cancer.
ISSN:0003-1348
1555-9823
DOI:10.1177/000313480907501002