Lymph node staging in colorectal cancer: Old controversies and recent advances

Table 1 Parameters affecting the clinical significance of lymph node staging in colorectal cancer

Extent of surgical lymph node removal

Thoroughness of the pathologist in dissecting the resection specimen

Technical methods to increase lymph node yield

Methylene blue injection

Fat clearing

Acetone compression

Changing definitions of lymph nodes, involved lymph nodes, and tumor deposits in different editions of the AJCC/UICC TNM staging system

History of neoadjuvant treatment

Absolute number of retrieved lymph nodes

Absolute number of positive lymph nodes

Lymph node ratio

Presence of extracapsular invasion

Sentinel node biopsy

Number of histological sections

Use of immunohistochemistry to identify micrometastasis and/or isolated tumor cells

Use of molecular techniques to identify minimal tumor disease in lymph node tissue

AJCC: American Joint Committee on Cancer; UICC: Union for International Cancer Control; TNM: Tumor node metastasis.