He F, Qu SP, Yuan Y, Qian K. Lymph node dissection does not affect the survival of patients with tumor node metastasis stages I and II colorectal cancer. World J Gastrointest Surg 2024; 16(8): 2503-2510 [DOI: 10.4240/wjgs.v16.i8.2503]
Corresponding Author of This Article
Kun Qian, PhD, Chief Doctor, Department of Gastrointestinal Surgery, The First Affiliated Hospital of Chongqing Medical University, No. 1 Youyi Road, Chongqing 400016, China. hxjsqk@hotmail.com
Research Domain of This Article
Oncology
Article-Type of This Article
Retrospective Cohort Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (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: http://creativecommons.org/licenses/by-nc/4.0/
World J Gastrointest Surg. Aug 27, 2024; 16(8): 2503-2510 Published online Aug 27, 2024. doi: 10.4240/wjgs.v16.i8.2503
Lymph node dissection does not affect the survival of patients with tumor node metastasis stages I and II colorectal cancer
Fan He, Shu-Pei Qu, Ye Yuan, Kun Qian
Fan He, Shu-Pei Qu, Ye Yuan, Kun Qian, Department of Gastrointestinal Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China
Co-first authors: Fan He and Shu-Pei Qu.
Author contributions: He F and Qu SP collected and analyzed the data; He F drafted the manuscript; Yuan Y completed the follow-up; Qian K designed the study; Yuan Y and Qian K reviewed the manuscript; All authors conduce to the manuscript revision and approved the submitted version.
Supported byChongqing Medical University Future Medical Youth Innovation Team Development Support Program, No. 03030299QC-W0007.
Institutional review board statement: The study was approved by the ethics committee of the First Affiliated Hospital of Chongqing Medical University was obtained (2022-K396).
Informed consent statement: The Ethics Committee waived the requirement for informed consent.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
Data sharing statement: The datasets used and analyzed during the current study are available from the corresponding author on reasonable request.
STROBE statement: The authors have read the STROBE Statement—checklist of items, and the manuscript was prepared and revised according to the STROBE Statement—checklist of items.
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: Kun Qian, PhD, Chief Doctor, Department of Gastrointestinal Surgery, The First Affiliated Hospital of Chongqing Medical University, No. 1 Youyi Road, Chongqing 400016, China. hxjsqk@hotmail.com
Received: May 12, 2024 Revised: July 5, 2024 Accepted: July 9, 2024 Published online: August 27, 2024 Processing time: 96 Days and 2.6 Hours
Abstract
BACKGROUND
The effect of the number of lymph node dissections (LNDs) during radical resection for colorectal cancer (CRC) on overall survival (OS) remains controversial.
AIM
To investigate the association between the number of LNDs and OS in patients with tumor node metastasis (TNM) stage I–II CRC undergoing radical resection.
METHODS
Patients who underwent radical resection for CRC at a single-center hospital between January 2011 and December 2021 were retrospectively analyzed. Cox regression analyses were performed to identify the independent predictors of OS at different T stages.
RESULTS
A total of 2850 patients who underwent laparoscopic radical resection for CRC were enrolled. At stage T1, age [P < 0.01, hazard ratio (HR) = 1.075, 95% confidence interval (CI): 1.019-1.134] and tumour size (P = 0.021, HR = 3.635, 95%CI: 1.210-10.917) were independent risk factors for OS. At stage T2, age (P < 0.01, HR = 1.064, 95%CI: 1.032-1.098) and overall complications (P = 0.012, HR = 2.297, 95%CI: 1.200-4.397) were independent risk factors for OS. At stage T3, only age (P < 0.01, HR = 1.047, 95%CI: 1.027-1.066) was an independent risk factor for OS. At stage T4, age (P < 0.01, HR = 1.057, 95%CI: 1.039-1.075) and body mass index (P = 0. 034, HR = 0.941, 95%CI: 0.890-0.995) were independent risk factors for OS. However, there was no association between LNDs and OS in stages I and II.
CONCLUSION
The number of LDNs did not affect the survival of patients with TNM stages I and II CRC. Therefore, insufficient LNDs should not be a cause for alarm during the surgery.
Core Tip: This retrospective cohort study aimed to investigate the association between the total number of lymph node dissections (LNDs) and overall survival (OS) in patients with tumor node metastasis stages I and II colorectal cancer who underwent laparoscopic radical resection. The results indicated that there was no association between the total number of LNDs and the OS in these patients. Therefore, insufficient LNDs should not be a cause for alarm during the surgery.
