ArticleInternational journal of colorectal disease2021
Evaluation of the prognostic relevance of the recommended minimum number of lymph nodes in colorectal cancer-a propensity score analysis.
Article in International journal of colorectal disease, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
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4 citing papers in PubMed, 7 citations in OpenAlex.
- Synergistic predictive value of T-stage and lymph node yield in guiding adjuvant radiotherapy decisions for pN1 OSCC without high-risk features: a multi-institutional retrospective cohort study.Clinical oral investigations · 2026Article
- Prognostic and Predictive Role of Lymph Node Count in Stage II Colon Cancer: A Retrospective Analysis of a Japanese Nationwide Cohort.Annals of gastroenterological surgery · 2026Article
- Clinical Significance of Lymph Node Count in Colon Cancer Surgery: A Tumour Location-stratified Prognostic Analysis Based on an Integrated Phase-III Randomized Controlled Trial (JCOG2310AS3).Journal of the anus, rectum and colon · 2026Article
- Development and validation of a survival prediction model for 113,239 patients with colon cancer: a retrospective cohort study.Journal of gastrointestinal oncology · 2022Article
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9 authors at 5 institutions in 3 countries.
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Abstract
purposeNodal status in colorectal cancer (CRC) is an important prognostic factor, and adequate lymph node (LN) staging is crucial. Whether the number of resected and analysed LN has a direct impact on overall survival (OS), cancer-specific survival (CSS) and disease-free survival (DFS) is much discussed. Guidelines request a minimum number of 12 LN to be analysed. Whether that threshold marks a prognostic relevant cut-off remains unknown.
methodsPatients operated for stage I-III CRC were identified from a prospectively maintained database. The impact of the number of analysed LN on OS, CSS and DFS was assessed using Cox regression and propensity score analysis.
resultsOf the 687 patients, 81.8% had ≥ 12 LN resected and analysed. Median LN yield was 17.0 (IQR 13.0-23.0). Resection and analysis of ≥ 12 LN was associated with improved OS (HR = 0.73, 95% CI: 0.56-0.95, p = 0.033), CSS (HR 0.52, 95% CI: 0.31-0.85, p = 0.030) and DFS (HR = 0.73, 95% CI: 0.57-0.95, p = 0.030) in multivariate Cox analysis. After adjusting for biasing factors with propensity score matching, resection of ≥ 12 LN was significantly associated with improved OS (HR = 0.59; 95% CI: 0.43-0.81; p = 0.002), CSS (HR = 0.34; 95% CI: 0.20-0.60; p < 0.001) and DFS (HR = 0.55; 95% CI: 0.41-0.74; p < 0.001) compared to patients with < 12 LN.
conclusionEliminating biasing factors by a propensity score matching analysis underlines the prognostic importance of the number of analysed LN. The set threshold marks the minimum number of required LN but nevertheless represents a cut-off regarding outcome in stage I-III CRC. This analysis therefore highlights the significance and importance of adherence to surgical oncological standards.
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