Should quality measures for lymph node dissection in colon cancer be extrapolated to rectal cancer?

BACKGROUND

A minimum of 12 lymph nodes has been endorsed as a quality measure to confirm node-negative colon cancer, but its relevance to early-stage rectal cancer is unclear.

METHODS

Patients with stage I or II rectal cancer from the Surveillance, Epidemiology and End Results tumor registries from 1998 to 2002 were identified. Patients were grouped by the number of lymph nodes sampled. Groups were compared for patient demographics, tumor characteristics, and 5-year overall survival.

RESULTS

Of the 6,214 patients (57% men) identified, only 33% had ≥12 lymph nodes examined in the surgical specimen. Multivariate analysis identified sex, race, age, T stage, and number of lymph nodes examined as independent predictors of 5-year overall survival.

CONCLUSIONS

Five-year overall survival improved as the number of sampled nodes increased. A thorough lymphadenectomy should routinely be performed to optimize staging and to improve survival of patients with early-stage rectal cancer.