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World J Gastroenterol. Dec 14, 2013; 19(46): 8515-8526
Published online Dec 14, 2013. doi: 10.3748/wjg.v19.i46.8515
Lymph node staging in colorectal cancer: Old controversies and recent advances
Annika Resch, Cord Langner
Annika Resch, Cord Langner, Institute of Pathology, Medical University of Graz, 8036 Graz, Austria
Author contributions: Resch A and Langner C contributed to design, literature research, and drafting of the article.
Correspondence to: Cord Langner, MD, Institute of Pathology, Medical University of Graz, Auenbruggerplatz 25, 8036 Graz, Austria. cord.langner@medunigraz.at
Telephone: +43-316-38513665 Fax: +43-316-38513432
Received: September 23, 2013
Revised: October 21, 2013
Accepted: November 3, 2013
Published online: December 14, 2013
Core Tip

Core tip: For patients with colorectal cancer, the indication for adjuvant therapy is mainly guided by the presence of regional lymph node metastasis. This review provides an in depth analysis of parameters affecting the clinical significance of lymph node staging, focusing on changing definitions of lymph nodes, involved lymph nodes, and tumor deposits in different editions of the American Joint Committee on Cancer/Union for International Cancer Control tumor node metastasis staging system, the minimum number of lymph nodes that should be evaluated, lymph node ratio, extracapsular invasion, sentinel node biopsy, and the potential benefit of ancillary techniques, such as immunohistochemistry and molecular analysis.