Letter to the Editor
Copyright ©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Surg. Dec 27, 2024; 16(12): 3895-3898
Published online Dec 27, 2024. doi: 10.4240/wjgs.v16.i12.3895
Does lymph node dissection improve the prognosis of patients with colorectal cancer?
Liang Wang, Shan-Shan Liu
Liang Wang, Department of Gastrointestinal Oncology Surgery, The Affiliated Hospital of Qinghai University, Xining 810000, Qinghai Province, China
Shan-Shan Liu, Graduate School of Qinghai University, The Affiliated Hospital of Qinghai University, Xining 810000, Qinghai Province, China
Co-first authors: Liang Wang and Shan-Shan Liu.
Author contributions: Wang L and Liu SS co-wrote the manuscript, sharing the first authorship; Wang L contributed to the manuscript concept and design; Liu SS reviewed the literature; Wang L revised and reviewed the manuscript; all authors have read and approved the final manuscript.
Conflict-of-interest statement: Dr. Wang has nothing to disclose.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Liang Wang, MD, Attending Doctor, Department of Gastrointestinal Oncology Surgery, The Affiliated Hospital of Qinghai University, No. 29 Tongren Road, Xining 810000, Qinghai Province, China. wangliang19911128@163.com
Received: August 5, 2024
Revised: September 28, 2024
Accepted: October 31, 2024
Published online: December 27, 2024
Processing time: 113 Days and 19.3 Hours
Abstract

The number of lymph nodes (LNs) dissected during surgery has become an interesting topic. Simple intuition always leads us to believe that dissecting more LNs will result in more accurate pathological staging and assurance of surgical quality. However, when the number of LNs dissected reaches a certain threshold, the patient’s prognosis does not continue to improve as the number of dissected nodes increases. Instead, an increase in the number of dissected LNs may be accompanied by a higher incidence of complications. Currently, there are only less than 40% of colorectal cancer patients undergoing adequate LN evaluation. Therefore, obtaining a sufficient number of LNs in clinical practice is extremely challenging. How to further address the insufficiency of LN dissection due to various reasons, which results in concerns of surgeons about patient prognosis, is currently a critical focus.

Keywords: Number of lymph nodes; Colorectal cancer; Overall survival; Tumor node metastasis; T stage

Core Tip: Much as obtaining a sufficient number of lymph nodes (LNs) is extremely important for determining the postoperative pathological stage and postoperative intervention treatment and improving the prognosis of colorectal cancer (CRC) patients, it remains a major challenge in clinical practice. The study by He et al confirmed no correlation between the number of LNs dissected in stage I-II CRC and overall survival, which alleviates the concerns of surgeons about insufficient LN dissection and its impact on patient prognosis. However, due to the limitations of this study, more studies are needed to validate the results.