Extent of surgery in cancer of the colon: Is more better?

Table 1 Variables confounding the association between nodal count and survival in colorectal cancer

Confounding variables		Effect on LNC
Patient characteristics	↑Age, ↓socioeconomic status, non-Caucasian race	↓
	gender, body mass index	?
Tumor characteristics	↑Tumor diameter, T stage, overall cancer stage, lymphocytic infiltration, MSI-H phenotype	↑
	↑Tumor grade	↓
	Mucinous differentiation, lymphovascular and perineural invasion	?
Surgical factors	Open vs minimally invasive resection	None
	Colorectal vs general surgeons, advanced fellowship training	↑
	Surgeon volume	?
Institutional factors	High-volume centers, teaching hospitals, significant CC surgical practice, academic pathology laboratories	↑
	Preoperative radiochemotherapy for rectal cancer	↓
Factors related to pathology examination	Xylene/alcohol fat clearance, embedding of the entire mesentery vs traditional dissection, ex vivo intra-arterial methylene blue injection, tattooing of neoplasms during colonoscopy, pathologists interested in CRC, use of a standardized protocol to evaluate CC specimens	↑

LNC: Lymph node count; CC: Colon cancer; CRC: Colorectal cancer; MSI: Microsatellite instability.