Number of Lymph Nodes Examined and Associated Clinicopathologic Factors in Colorectal Carcinoma (Report‪)‬

Colorectal carcinoma is the second most common cause of cancer deaths in the United States. (1) The most important prognostic factor in colorectal carcinoma is the nodal status at the time of surgical treatment. The 5-year survival rate for stages I and II colorectal carcinomas is greater than 75%. With nodal metastasis, the 5-year survival rate drops dramatically to from 40% to 60%. (2) The presence of nodal metastasis is one of the key determining factors for undergoing postoperative adjuvant therapy and is also a key factor in predicting disease-free and longterm survival. (3-5) The standard treatments of stages I and II colon cancer are surgical removal of the cancer with clear surgical margins and adequate regional lymph node dissection. For stages II and III rectal cancers, neoadjuvant chemoradiation is indicated. Additional treatment with chemotherapy or radiotherapy is often the standard treatment of stages III and IV colorectal cancers. It is still controversial whether chemotherapy should be selectively added for certain patients with stage II colon cancer and high risk factors, such as poorly differentiated tumors, tumor perforation, and limited number of lymph nodes examined. A growing body of evidence suggests that the prognosis of certain patients with stage II cancer and unfavorable prognostic factors can be improved by adjuvant chemotherapy. (6,7)