Factors influencing lymph node retrieval and staging in colorectal cancer resections: a single-centre study.

introductionColorectal cancer (CRC) ranks globally as the third most common cancer and fourth leading cause of death. Adequate lymph node evaluation is vital for prognosis and treatment, with the AJCC emphasizing the importance of dissected lymph nodes. The AJCC recommends examination of a minimum of 12 total dissected lymph nodes to stage colorectal cancer accurately. This study aimed to explore factors influencing lymph node retrieval and their impact on nodal positivity and the N category in colorectal cancer staging.

methodsThis retrospective single-centre study involved CRC patients who underwent laparoscopic excision by a single colorectal surgeon between July 2021 and July 2023. Data were extracted from the hospital's electronic database, with exclusion criteria for benign conditions.

resultsThe average number of LNs in this cohort was 17.95 ± 6.55. At least 12 LNs were recovered in 90.91% of the cases. The right colon was the most common tumour site. Right hemicolectomy, transverse colon resection and sigmoid colectomy achieved 100% compliance with adequate retrieval criteria. An increase in LN retrieval was observed with higher T stages. There was a positive linear correlation of the number of harvested LNs with the length of the resected bowel. No significant difference in LN yield was observed between node-positive and node-negative cases.

conclusionLN harvest in CRC patients is influenced primarily by tumour location and surgical procedure, with adequate staging achievable through meticulous technique, as total lymph node count did not correlate with nodal positivity or N category in this cohort.