According to results recently published in the Journal of Clinical Oncology, adequate removal of lymph nodes affects accurate staging of colorectal cancer. Furthermore, patients with colorectal cancer who do not undergo adequate removal of lymph nodes have a reduced survival.
Colorectal cancer is one of the leading causes of cancer-related deaths in the United States. Accurate staging, or determining the exact extent of spread of cancer, is a necessary step in providing optimal treatment choices for patients. One component to staging for colorectal cancer is the removal of lymph nodes that are near the site of the cancer during the surgery to remove the cancer, a process referred to as lymphadenectomy. Pathologists can provide more accurate staging by determining if the cancer has spread to the lymph nodes, which thus allows for optimal treatment options.
Recent results have indicated that the number of lymph nodes removed during a lymphadenectomy affects staging and survival of patients with colorectal cancer. Researchers continue to evaluate the optimal number of lymph nodes to be removed, as well as the effects on overall outcomes.
Researchers from England recently conducted another clinical study to further evaluate the effects of the extent of a lymphadenectomy among patients with colorectal cancer. This study included over 7,000 patients who had undergone surgery between 1995 and 2003 for colorectal cancer.
- The median number of lymph nodes removed was seven in 1995; that number then increased to 13 in 2003.
- The number of lymph nodes removed decreased as a patient’s age increased.
- At five years survival was lower among patients with fewer lymph nodes removed.
- An adequate removal of lymph nodes during a lymphadenectomy (at least 12 lymph nodes) was more commonly accomplished when the surgery and pathology were performed by specialists in the respective fields.
- Staging accuracy was improved if an adequate lymphadenectomy was performed.
The researchers concluded that removal of a larger number of lymph nodes during a lymphadenectomy improves outcomes among patients with colorectal cancer. An adequate lymphadenectomy occurs more frequently among younger patients and when care is performed by a specialist. Patients diagnosed with colorectal cancer should speak with their physician regarding an optimal lymphadenectomy.
Reference: Morris E, Maughan N, Forman D, Quirke P, et al. Identifying Stage III colorectal cancer patients: the Influence of the patient, surgeon, and pathologist. Journal of Clinical Oncology. 2007;25: 2573-2579.