Lymph node dissection does not affect the survival of patients with tumor node metastasis stages I and II colorectal cancer

doi:10.4240/wjgs.v16.i8.2503

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Aug 27, 2024 (publication date) through Mar 7, 2026

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World Journal of Gastrointestinal Surgery

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1948-9366

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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA

Retrospective Cohort Study

World J Gastrointest Surg. Aug 27, 2024; 16(8): 2503-2510
Published online Aug 27, 2024. doi: 10.4240/wjgs.v16.i8.2503

Lymph node dissection does not affect the survival of patients with tumor node metastasis stages I and II colorectal cancer

Fan He, Shu-Pei Qu, Ye Yuan, Kun Qian

Fan He, Shu-Pei Qu, Ye Yuan, Kun Qian, Department of Gastrointestinal Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China

Co-first authors: Fan He and Shu-Pei Qu.

Author contributions: He F and Qu SP collected and analyzed the data; He F drafted the manuscript; Yuan Y completed the follow-up; Qian K designed the study; Yuan Y and Qian K reviewed the manuscript; All authors conduce to the manuscript revision and approved the submitted version.

Supported by Chongqing Medical University Future Medical Youth Innovation Team Development Support Program, No. 03030299QC-W0007.

Institutional review board statement: The study was approved by the ethics committee of the First Affiliated Hospital of Chongqing Medical University was obtained (2022-K396).

Informed consent statement: The Ethics Committee waived the requirement for informed consent.

Conflict-of-interest statement: The authors declare that they have no conflict of interest.

Data sharing statement: The datasets used and analyzed during the current study are available from the corresponding author on reasonable request.

STROBE statement: The authors have read the STROBE Statement—checklist of items, and the manuscript was prepared and revised according to the STROBE Statement—checklist of items.

Corresponding author: Kun Qian, PhD, Chief Doctor, Department of Gastrointestinal Surgery, The First Affiliated Hospital of Chongqing Medical University, No. 1 Youyi Road, Chongqing 400016, China. hxjsqk@hotmail.com

Received: May 12, 2024
Revised: July 5, 2024
Accepted: July 9, 2024
Published online: August 27, 2024
Processing time: 96 Days and 2.6 Hours

Abstract

BACKGROUND

The effect of the number of lymph node dissections (LNDs) during radical resection for colorectal cancer (CRC) on overall survival (OS) remains controversial.

AIM

To investigate the association between the number of LNDs and OS in patients with tumor node metastasis (TNM) stage I–II CRC undergoing radical resection.

METHODS

Patients who underwent radical resection for CRC at a single-center hospital between January 2011 and December 2021 were retrospectively analyzed. Cox regression analyses were performed to identify the independent predictors of OS at different T stages.

RESULTS

A total of 2850 patients who underwent laparoscopic radical resection for CRC were enrolled. At stage T1, age [P < 0.01, hazard ratio (HR) = 1.075, 95% confidence interval (CI): 1.019-1.134] and tumour size (P = 0.021, HR = 3.635, 95%CI: 1.210-10.917) were independent risk factors for OS. At stage T2, age (P < 0.01, HR = 1.064, 95%CI: 1.032-1.098) and overall complications (P = 0.012, HR = 2.297, 95%CI: 1.200-4.397) were independent risk factors for OS. At stage T3, only age (P < 0.01, HR = 1.047, 95%CI: 1.027-1.066) was an independent risk factor for OS. At stage T4, age (P < 0.01, HR = 1.057, 95%CI: 1.039-1.075) and body mass index (P = 0. 034, HR = 0.941, 95%CI: 0.890-0.995) were independent risk factors for OS. However, there was no association between LNDs and OS in stages I and II.

CONCLUSION

The number of LDNs did not affect the survival of patients with TNM stages I and II CRC. Therefore, insufficient LNDs should not be a cause for alarm during the surgery.

Keywords: Lymph nodes; Colorectal cancer; T stage; Overall survival; Cox regression analyses

Core Tip: This retrospective cohort study aimed to investigate the association between the total number of lymph node dissections (LNDs) and overall survival (OS) in patients with tumor node metastasis stages I and II colorectal cancer who underwent laparoscopic radical resection. The results indicated that there was no association between the total number of LNDs and the OS in these patients. Therefore, insufficient LNDs should not be a cause for alarm during the surgery.