Background: The number of lymph nodes evaluated may be a measure of quality in colon cancer care and appears to be inadequate in most patients treated for colon cancer. We performed a systematic review of the evidence for the association between lymph node evaluation and oncologic outcomes in patients with colon cancer.
Aim: The adequate lymph node evaluation for cancer involvement, prognosis and adequate treatment of patients with colon cancer.
Method: It included information about diagnosis, patient age at diagnosis, the surgical procedure that was performed, anatomic location of the cancer, histology, tumor size, number of LN identified, number of LN positive for cancer, general stage (local, regional or to distance, TNM stage /A7CC). Rectal cancer was excluded. We analyzed data from the cancer registry of 1st Surgical Clinic of Sibiu including 287 patients with colon cancer. This registry includes follow-up information from 1998 to 2009. Identification of ≥12 LN (lymph nodes) in resected colon cancer specimens has been considered as a quality indicator. In patients with resected colorectal cancer, LN the involvement has particular importance for patient prognosis and adjuvant therapy.
Results: The average number of LN identified increased from 6±3 during 1998–2003, to 14±5 during 2003–2009. The proportion of patients diagnosed with positive LN increased from 31.6% during 1998–2003 to 37% during 2003–2009. No significant change in the proportion of patients diagnosed with just one positive LN (10% versus 10.6%) was observed.
Conclusion: The results suggest a relationship between the survival and identification of 12+ LN for stage I or II, considering the disease.