Is increasing nodal count associated with improved recurrence-free and overall survival following standard right hemicolectomy for cancer?
Journal Title
Journal of Surgical Oncology
Publication Type
epub ahead of print
Abstract
BACKGROUND AND OBJECTIVES: Increasing lymph node harvest for right-sided colon cancer is associated with improved overall survival (OS) but most relevant studies failed to report the extent of resection. We examined the association between increasing lymph node count with standard right hemicolectomy according to nodal status and prognostic outcomes in right-sided tumors. METHODS: Retrospective analysis of prospectively-collected clinical data from patients with proximal colonic adenocarcinomas (n=1390) following right hemicolectomy. Associations between lymph node counts (0-12 versus 13-15, 16-20 and >20) and recurrence-free survival (RFS) and OS were examined using multivariate Cox modelling adjusted for confounders. RESULTS: We found no association between increasing nodal count and RFS, regardless of nodal status. In the absence of nodal metastases, increasing nodal count (16-20 and >20 vs 0-12 nodes) was associated with 57% (95%CI 0.21-0.89) and 52% (95%CI 0.24-0.95) improved OS, respectively. In the presence of nodal metastases, increasing nodal count was not associated with OS. Adjuvant chemotherapy did not modify this effect. CONCLUSION: Increasing nodal count (>15 nodes) with right hemicolectomy was not associated with improved RFS. Improved OS was only found for node negative tumors, casting some doubt on the benefits of resecting more lymph nodes in the presence of nodal metastases. This article is protected by copyright. All rights reserved.
Publisher
Wiley
Keywords
nodal count; overall survival; proximal colon cancer; recurrence-free survival; right hemicolectomy
WEHI Research Division(s)
Personalised Oncology
PubMed ID
35481710
Open Access at Publisher's Site
https://doi.org/10.1002/jso.26913
Terms of Use/Rights Notice
Refer to copyright notice on published article.


Creation Date: 2022-05-03 09:18:31
Last Modified: 2022-05-03 09:27:56
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