SP 3.06 Adequacy of Lymph Node Harvest and Its Impact on Outcomes Following Colorectal Cancer Resection: Implications for Surgical and Pathological Optimisation
Ahmed Kassem, Mohamed Ahmed, Khaled HureibiAbstract
Background
Adequate (LN) harvest is established quality indicator in colorectal cancer surgery and essential for accurate pathological staging. Current guidelines recommend retrieval of at least twelve lymph nodes; however, impact of LN harvest adequacy on postoperative morbidity and long-term oncological outcomes remains unclear. This study aimed to evaluate the association between adequate LN harvest and short- and long-term outcomes following colorectal cancer resection.
Methods
A retrospective cohort study conducted including 415 patients underwent curative colorectal cancer resection between 2020 - 2023. Adequate LN harvest was defined as retrieval of more than twelve lymph nodes. Data collected included tumour site, surgeon specialty, total, positive LN count, postoperative complications and their type, reoperation, readmission or disease recurrence within five years. Associations between LN harvest adequacy, outcomes analysed using chi-square, Fisher’s exact tests as appropriate. A p-value less than 0.05 was considered statistically significant.
Results
Adequate LN harvest achieved in 356 of 401 patients (88.8%). No significant association between LN harvest adequacy and overall postoperative complications (28.7% vs 28.9%, p=1.00) or five-year recurrence rates (21.7% vs 25.6%, p=0.72). Inadequate LN harvest was associated with significantly higher reoperation rates (26.7% vs 10.7%, p=0.006). Tumour site was significantly associated with LN harvest adequacy (p<0.001), with lower adequacy rates observed in rectal and rectosigmoid tumours. Surgeon specialty was not significantly associated with achieving adequate LN harvest (p=0.33).
Conclusion
Adequate LN harvest was not associated with increased postoperative morbidity or reduced recurrence but was significantly influenced by tumour site. Inadequate LN harvest was associated with higher reoperation rates.