According to an article recently published in the Journal of the National Cancer Institute, patients with Stage II and III colon cancer have improved survival when a greater number of lymph nodes are removed during surgery.
The colon is the largest part of the large intestine. Stage II and III colon cancers refer to cancer that has penetrated the colon and entered the abdominal cavity; there may be spread to local lymph nodes but cancer is not detected elsewhere in the body. The removal of nearby lymph nodes is a routine part of treatment for patients with Stage II or III colon cancer. Physicians typically remove the lymph nodes during the surgery to remove the cancer. The lymph nodes are then tested in a laboratory to determine if the cancer has spread. However, the optimal number of lymph nodes to remove and evaluate has not been established.
Researchers from Texas recently conducted a clinical study to evaluate data regarding the removal of lymph nodes in patients with Stage II or III colon cancer. The study included data from 17 studies conducted in nine countries and involved nearly 61, 400 patients. All 17 studies included patients with Stage II colon cancer, and six studies included data from patients with Stage III colon cancer. Patients had anywhere from six to 40 lymph nodes and evaluated.
- Sixteen of the 17 studies indicated that patients with Stage II colon cancer had significantly improved survival when more lymph nodes were removed.
- Four of six studies that included patients with Stage III colon cancer demonstrated significantly improved survival when more lymph nodes were removed.
The researchers concluded that removing a larger the number of lymph nodes is associated with improved survival for patients with Stage II and III colon cancer.
Patients diagnosed with Stage II or III colon cancer may wish to speak with their physician regarding lymph node removal. The authors state, “These results support consideration of the number of lymph nodes evaluated as a measure of the quality of colon cancer care.”
Reference: Chang G, Rodriguez-Bigas M, Skibber J, Moyer V. Lymph node evaluation and survival after curative resection of colon cancer: systematic review. Journal of the National Cancer Institute. 2007; 99: 433-441.