S. Parikh1, K. Weber1, M. Kobritz1, R. Hollis1, S. Gurien1, M. Greenwald1 1North Shore University And Long Island Jewish Medical Center, Surgery, Manhasset, NY, USA
Introduction:
Identification of positive lymph nodes in colon cancer can have significant impacts on treatment. Few studies have examined the relationship of lymph node size and its role in staging and prognosis. This study attempted to describe an association between lymph node size on pathology and metastatic colon cancer.
Methods:
Retrospective chart review was performed for patients undergoing colectomy for right-sided colon cancers between 2015-2020 across a single multi-hospital health system. Patients under age 18, or who did not have invasive adenocarcinoma on pathology were excluded. Primary endpoints assessed node size and nodal metastasis. 581 patients were stratified by lymph node size; any nodes equal to or greater than 0.5cm (n=314) were characterized as enlarged. A chi-square test was performed to analyze the differences in metastatic disease between patients with normal and enlarged lymph nodes.
Results:
Demographics were not statistically significant between the two groups. The mean age was 72.4 vs 71.2 years (p= 0.22) in the normal and enlarged nodes group respectively. Gender and ethnicity were also similar among the two groups. There was no difference in lymph node sampling between the two groups (Table 1). 33.9% of all lymph nodes examined were positive for metastatic spread. Patients with enlarged lymph nodes were significantly more likely to have positive lymph nodes than those with normal lymph nodes (p=0.0003; Table 1).
Conclusion:
Patients with enlarged nodes (equal to or greater than 0.5cm) were significantly more likely to have evidence of metastasis than those with normal sized nodes. Further research to identify these enlarged lymph nodes on radiologic imaging is warranted to determine the role in pre-operative staging.
