Lymph node sampling for rectal cancer: How much is enough?

Abstract

Current guidelines recommend that at least 12 lymph nodes should be evaluated during colon cancer resection in order to ensure adequate staging. However, the minimum number of lymph nodes that should be assessed in curative treatment for rectal cancer has yet to be defined, and a 12 lymph node minimum may not be generalizable to this group of patients. Accurate nodal staging in rectal cancer is further complicated by the use of preoperative chemoradiation in locally advanced disease, which has been associated with a decrease in the number of identifiable lymph nodes. The number of lymph nodes evaluated in patients with rectal cancer affects staging and prognosis; however, further study is warranted before standards for a minimum number of lymph nodes that should be examined can be firmly established.