Published online May 15, 2016. doi: 10.4251/wjgo.v8.i5.466
Peer-review started: October 1, 2015
First decision: November 13, 2015
Revised: December 15, 2015
Accepted: March 7, 2016
Article in press: March 9, 2016
Published online: May 15, 2016
Processing time: 223 Days and 18.1 Hours
There are numerous factors which can affect the lymph node (LN) yield in colon cancer specimens. The aim of this paper was to identify both modifiable and non-modifiable factors that have been demonstrated to affect colonic resection specimen LN yield and to summarise the pertinent literature on these topics. A literature review of PubMed was performed to identify the potential factors which may influence the LN yield in colon cancer resection specimens. The terms used for the search were: LN, lymphadenectomy, LN yield, LN harvest, LN number, colon cancer and colorectal cancer. Both non-modifiable and modifiable factors were identified. The review identified fifteen non-surgical factors: (13 non-modifiable, 2 modifiable) which may influence LN yield. LN yield is frequently reduced in older, obese patients and those with male sex and increased in patients with right sided, large, and poorly differentiated tumours. Patient ethnicity and lower socioeconomic class may negatively influence LN yield. Pre-operative tumour tattooing appears to increase LN yield. There are many factors that potentially influence the LN yield, although the strength of the association between the two varies greatly. Perfecting oncological resection and pathological analysis remain the cornerstones to achieving good quality and quantity LN yields in patients with colon cancer.
Core tip: Surgeons, pathologists and patients alike must appreciate that there are many factors which influence lymph node (LN) yield in resected colon cancer specimens. Clinicians must strive for the perfect oncological operation and pathological analysis. However, clinicians should be aware that despite optimal surgery and pathological analysis, other factors may influence the LN yield following colonic resection for cancer.