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

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.