Predictors of adequate lymph node harvest during colectomy for colon cancer

Jeffrey Douaiher, Tanvir Hussain, Sean J. Langenfeld

Research output: Contribution to journalArticle

1 Scopus citations

Abstract

Background: Consensus guidelines recommend a yield of 12 lymph nodes in resections for colon cancer. Factors affecting this yield are not well defined. Methods: Retrospective study using the colectomy-targeted American College of Surgeons National Surgical Quality Improvement Program for years 2014–2016. Primary outcome was resection of at least 12 nodes. Univariate and multivariate analyses determined factors associated with ≥12 LN yield. Results: 17,612 colectomies for colon cancer were extracted from the NSQIP database. 7.26% of cases did not reach a 12 LN harvest. Harvesting ≥12 LN was 74% more likely (p = 0.001) if the resection was laparoscopic and 72% more likely (p < 0.0001) if hand-assisted. Advanced T and N stage had a higher likelihood of reaching 12 LN harvest. Older age, female gender and smoking history decreased the likelihood of ≥12 LN harvest. Conclusions: Laparoscopic and robotic colectomies were 1.5–2.5 times more likely to achieve adequate LN harvest compared to open surgery. Several non-modifiable patient and disease related factors may render adequate LN yield challenging.

Original languageEnglish (US)
Pages (from-to)113-118
Number of pages6
JournalAmerican journal of surgery
Volume218
Issue number1
DOIs
Publication statusPublished - Jul 2019

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Keywords

  • Colectomy
  • Colon cancer
  • Lymph node harvest
  • Outcomes
  • Surgical quality

ASJC Scopus subject areas

  • Surgery

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