©The Author(s) 2015. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Nov 21, 2015; 21(43): 12218-12233
Published online Nov 21, 2015. doi: 10.3748/wjg.v21.i43.12218
Published online Nov 21, 2015. doi: 10.3748/wjg.v21.i43.12218
Stage migration vs immunology: The lymph node count story in colon cancer
Bruno Märkl, Institute of Pathology, Klinikum Augsburg, 86156 Augsburg, Germany
Author contributions: Märkl B contributed to this paper.
Conflict-of-interest statement: The author has no competing commercial, personal, political, intellectual, or religious interests in relation to the submitted work to declare.
Correspondence to: Dr. Bruno Märkl, Privatdozent, Institute of Pathology, Klinikum Augsburg, Stenglinstrasse 2, 86156 Augsburg, Germany. bruno.maerkl@klinikum-augsburg.de
Telephone: +49-821-4003199 Fax: +49-821-400173199
Received: May 14, 2015
Peer-review started: May 15, 2015
First decision: July 14, 2015
Revised: September 1, 2015
Accepted: October 23, 2015
Article in press: October 26, 2015
Published online: November 21, 2015
Processing time: 187 Days and 18.8 Hours
Peer-review started: May 15, 2015
First decision: July 14, 2015
Revised: September 1, 2015
Accepted: October 23, 2015
Article in press: October 26, 2015
Published online: November 21, 2015
Processing time: 187 Days and 18.8 Hours
Core Tip
Core tip: The number of evaluated lymph nodes is prognostic in stage II and III colon cancers. Understaging due to inadequate lymph node harvest causing a stage migration effect is a widely accepted explanation for this. However, there is growing evidence that understaging plays only a minor role in this context. It seems much more likely that immune response has influence on the lymph nodes’ detectability and is associated with outcome in colon cancer.