Should there be a specific length of the colon-rectum segment to be resected for an adequate number of lymph nodes in cases of colorectal cancers? A retrospective multi-center study
Orhan Üreyen1, Cemal Ulusoy2, Atahan Acar3, Fazıl Sağlam2, İlker Kızıloğlu1, Ali Alemdar2, Kemal Murat Atahan3, Emrah Dadalı1, Serkan Karaisli3, Mehmet Can Aydın2, Enver İlhan1, Hakan Güven2
1Clinic of General Surgery, Health Sciences University, Izmir Bozyaka Training and Research Hospital, Izmir, Turkey
2Clinic of General Surgery, Health Sciences University, Istanbul Okmeydani Training and Research Hospital, Istanbul, Turkey
3Clinic of General Surgery, Izmir Katip Celebi University, Ataturk Training and Research Hospital, Izmir, Turkey
Objective: This study aimed to evaluate the question as to whether there should be a certain length of the colon-rectum segment to be resected for correct lymph node staging in cases with colorectal cancer.
Material and Methods: The files and electronic datas of the patients had been undergone surgery for colorectal cancer between January 2011 and June 2016 were evaluated. The patients were divided into two groups; Group I= ≥ 12 lymph nodes, and Group II= lymph nodes less than 12 (< 12) lymph nodes.
Results: Mean age of the 327 participants in this study was 64.30 ± 12.20. Mean length of resected colon-rectum segment was 25.61 (± 14.07) cm; mean number of dissected lymph nodes was 20.63 ± 12.30. Median length of the resected colon was 24 cm (range: 145-6) in Group I and 20 cm (range: 52-9) in Group II; a significant difference was found between the groups (p= 0.002). Factors associated with adequate lymph node dissection included type of the operation (p= 0.001), tumor location (p= 0.005), tumor T stage (p= 0.001), condition of metastasis in the lymph node (p= 0.008) and stage of the disease (p= 0.031). Overall survival was 62.4 ± 1.31 months, and Group I and Group II survival was 61.4 ± 1.39 months and 66.7 ± 3.25 months, respectively (p= 0.449).
Conclusion: Results of the study showed that ≥ 12 lymph nodes would likely be dissected when the length of the resected colon-rectum segment is > 21 cm. We conclude that the removed colonic size can be significant when performed with oncological surgical standardization.
Keywords: Colorectal cancer, colectomy, lymph nodes
Cite this article as: Üreyen O, Ulusoy C, Acar A, Sağlam F, Kızıloğlu İ, Alemdar A, et al. Should there be a specific length of the colon-rectum segment to be resected for an adequate number of lymph nodes in cases of colorectal cancers? A retrospective multi-center study. Turk J Surg 2020; 36 (1): 23-32.
Approval was obtained from the Clinical Research Ethics Committee (Application date: 08/02/2017; Application No: 20, Dated: 15/02/2017 with Decision No: 1).
Patient consent was obtained.
Concept - O.Ü., M.K.A., E.İ.; Design - O.Ü., F.S., C.Ü., H.G.; Supervision - A.A., H.G., A.Acar., S.K.; Resource - S.K., A.Acar., E.D., E.İ.; Materials - O.Ü., M.C.A., C.U., İ.K.; Data Collection and/or Processing - A.Acar., M.C.A., E.D.; Analysis and/or Interpretation - E.İ., H.G., C.U., A.A., İ.K., S.K.; Literature Review - O.Ü., M.K.A., F.S., M.C.A.; Writing Manuscript - O.Ü., C.U., A.Acar., E.İ., H.G., Critical Reviews - F.S., A.A., İ.K., M.K.A., E.D.
The authors have no conflicts of interest to declare.
The authors declared that this study has received no financial support.