Factors affecting the number of retrieved lymph nodes and the impact on the prognosis in Stage II/III right-sided colon cancer.

IF 2.3 4区医学 Q2 SURGERY

Surgery Today Pub Date : 2026-10-01 Epub Date: 2026-06-04 DOI:10.1007/s00595-026-03349-2

Rika Ono, Tetsuro Tominaga, Yuma Takamura, Hiroki Katayama, Shintaro Hashimoto, Mariko Yamashita, Hiroshi Maruta, Keisuke Noda, Makoto Hisanaga, Kaido Oishi, Masaaki Moriyama, Fumitake Uchida, Toshio Shiraishi, Masaki Kunizaki, Takashi Nonaka, Keitaro Matsumoto

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引用次数: 0

Abstract

Purpose: The risk factors and prognostic implications of retrieving fewer than 12 lymph nodes in patients undergoing laparoscopic/robot-assisted right colectomy remain unclear.

Methods: A total of 993 patients with Stage II/III right-sided colon cancer who underwent minimally invasive surgery between 2016 and 2024 were reviewed. Patients were divided into two groups: those with < 12 retrieved lymph nodes (low lymph node [L-LN] group, n = 139) and those with ≥ 12 retrieved lymph nodes (high lymph node [H-LN] group, n = 854). The clinicopathological characteristics and prognosis were compared between the groups.

Results: A multivariate analysis revealed that BMI > 25 kg/m² (odds ratio [OR] 1.508; 95% confidence interval [CI] 1.004-2.266; p = 0.047), no colonic stent insertion (OR 3.500; 95%CI 1.077-11.378: p = 0.037), and a clinical node-negative status (OR 1.535 95%CI 1.050-2.242: p = 0.026) were independent predictors of retrieval of < 12 lymph nodes. In both Stage II (100% vs. 79.5%, p < 0.05) and Stage III (100% vs. 63.6%, p = 0.07) patients, adjuvant chemotherapy resulted in better outcomes than no adjuvant chemotherapy.

Conclusion: In minimally invasive right colectomy, a high BMI and clinically node-negative disease were associated with a reduced number of dissected lymph nodes. As potentially inadequate dissection may contribute to a poor prognosis, adjuvant therapy should be considered in selected patients.

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ⅱ/ⅲ期右侧结肠癌淋巴结清扫数的影响因素及对预后的影响

目的：腹腔镜/机器人辅助右结肠切除术患者摘除少于12个淋巴结的危险因素和预后影响尚不清楚。方法：回顾性分析2016年至2024年间行微创手术的993例II/III期右侧结肠癌患者。结果：多因素分析显示BMI为25 kg/m2（优势比[OR] 1.508； 95%可信区间[CI] 1.004-2.266; p = 0.047），未植入结肠支架(OR 3.500；95%CI 1.077-11.378: p = 0.037)和临床淋巴结阴性状态（OR 1.535 95%CI 1.050-2.242: p = 0.026）是切除的独立预测因素。结论：在微创右结肠切除术中，高BMI和临床淋巴结阴性疾病与清扫淋巴结数量减少相关。由于潜在的不充分的解剖可能导致预后不良，因此应在选定的患者中考虑辅助治疗。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Surgery Today 医学-外科

CiteScore

4.90

自引率

4.00%

发文量

208

审稿时长

1 months

期刊介绍： Surgery Today is the official journal of the Japan Surgical Society. The main purpose of the journal is to provide a place for the publication of high-quality papers documenting recent advances and new developments in all fields of surgery, both clinical and experimental. The journal welcomes original papers, review articles, and short communications, as well as short technical reports("How to do it"). The "How to do it" section will includes short articles on methods or techniques recommended for practical surgery. Papers submitted to the journal are reviewed by an international editorial board. Field of interest: All fields of surgery.