Morera-Ocon FJ, Navarro-Campoy C, Cardona-Henao JD, Landete-Molina F. Colorectal cancer lymph node dissection and disease survival. World J Gastrointest Surg 2024; 16(12): 3890-3894 [DOI: 10.4240/wjgs.v16.i12.3890]
Corresponding Author of This Article
Francisco J Morera-Ocon, PhD, Doctor, Department of General Surgery, Hospital General de Requena, Paraje Casablanca s/n, Requena 46340, Spain. fmoreraocon@gmail.com
Research Domain of This Article
Oncology
Article-Type of This Article
Letter to the Editor
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Gastrointest Surg. Dec 27, 2024; 16(12): 3890-3894 Published online Dec 27, 2024. doi: 10.4240/wjgs.v16.i12.3890
Colorectal cancer lymph node dissection and disease survival
Francisco J Morera-Ocon, Clara Navarro-Campoy, John Deiver Cardona-Henao, Francisco Landete-Molina
Francisco J Morera-Ocon, Francisco Landete-Molina, Department of General Surgery, Hospital General de Requena, Requena 46340, Spain
Clara Navarro-Campoy, Department of Gynecology, Hospital Vithas 9 Octubre, Valencia 46015, Spain
John Deiver Cardona-Henao, Department of Pathology, Hospital General de Requena, Requena 46340, Spain
Author contributions: Morera-Ocon FJ drafted the manuscript; Morera-Ocon FJ and Navarro-Campoy C translated and completed the manuscript; Cardona-Henao JD collected the data; Landete-Molina F reviewed the manuscript. All authors contributed to the manuscript revision and approved the submitted version.
Conflict-of-interest statement: The authors declare that they have no conflicts of interest related to the article.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Francisco J Morera-Ocon, PhD, Doctor, Department of General Surgery, Hospital General de Requena, Paraje Casablanca s/n, Requena 46340, Spain. fmoreraocon@gmail.com
Received: July 30, 2024 Revised: September 15, 2024 Accepted: October 18, 2024 Published online: December 27, 2024 Processing time: 119 Days and 19.8 Hours
Abstract
The debate regarding the two possible roles of lymphadenectomy in surgical oncology, prognostic or therapeutic, is still ongoing. Furthermore, the use of lymphadenectomy as a proxy for the quality of the surgical procedure is another feature of discussion. Nevertheless, this reckoning depends on patient conditions, aggressiveness of the tumor, the surgeon, and the pathologist, and then it is not an absolute surrogate for the surgical quality. The international guidelines recommend a minimum of 12 lymph nodes harvested for pathological examination in colorectal cancer (CRC) surgery. There is a growing literature on reporting better survival when the lymph node yield is high, even when these nodes are negative for malignancy. On the other hand, there are studies reporting no survival benefit with high lymph node yield in stage I-II of CRC. Herein we review the roles of the lymphadenectomy in CRC, and discuss the results of studies on lymph node harvesting.
Core Tip: The lymph node yield (LNY) cannot be considered a significant reliable factor in assessing the quality of surgical resection. The aim of the surgeon includes obtaining an intact specimen, and the role of the pathologist includes collecting a high LNY for microscopic examination and reporting the accurate tumor node metastasis (TNM). The involvement of the lymph nodes and the final T and N of TNM can only be known after removing the specimen. Features considering the association with LNY and survival remain issues beyond this step, therefore diligent search for lymph nodes is required on gross examination of the surgical specimen.
